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General NPI Number Information
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NPI Number | 1972645075
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Entity Type | Individual
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Provider Name | KIMBERLY BLAND WHNP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MTSU -MCFARLAND STUDENT HEALTH SERVICES 1301 EAST MAIN ST.
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City | MURFREESBORO
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State | TN
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Zip | 37132-0001
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Country | US
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Telephone | 615-904-8402
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Fax | 615-494-7757
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Provider Business Mailing Address
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Address Line | 5247 ST. IVES DR.
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City | MURFREESBORO
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State | TN
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Zip | 37128
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Country | US
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Telephone |
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 11165
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License Number State | TN
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