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General NPI Number Information
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NPI Number | 1841716636
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Entity Type | Individual
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Provider Name | KIMBERLY JAUDON KISER APRN
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Gender | Female
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 613 23RD ST STE 440
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City | ASHLAND
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State | KY
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Zip | 41101
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Country | US
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Telephone | 606-329-2888
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Fax | 606-329-2890
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone | 606-408-6200
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Fax | 606-408-6612
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3011550
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License Number State | KY
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