MEDICARE: KIMBERLY MARSH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN-NP115732	GA

General Provider Information

NPI Number	:	1003767575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MARSH

Provider Business Mailing Address
First Line	:	3902 WEATHERBY LN
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-0877
Country	:	US
Telephone Number	:	904-465-7999
Fax Number	:	904-465-7999

Provider Business Practice Location Address
First Line	:	3902 WEATHERBY LN
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-0877
Country	:	US
Telephone Number	:	904-465-7999
Fax Number	:	904-465-7999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ KIMBERLY MARSH ” Practice Location

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