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General NPI Number Information
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NPI Number | 1760617005
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Entity Type | Individual
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Provider Name | KIMBERLY MARIE KINKADE APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 02/09/2025
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Provider Practice Location Address
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Address Line | 2067 CHARLIE HALL BLVD
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City | CHARLESTON
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State | SC
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Zip | 29414-5834
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Country | US
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Telephone | 843-573-2535
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Fax | 843-573-2534
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Provider Business Mailing Address
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Address Line | PO BOX 602108
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City | CHARLOTTE
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State | NC
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Zip | 28260-2108
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Country | US
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Telephone | 843-573-2535
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Fax | 843-573-2534
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 25520
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License Number State | SC
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