MEDICARE: DR. KIMBERLY DAWN ERNST M.D.

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	2080N0001X	Neonatal-Perinatal Medicine Physician	23319	OK
2	2080N0001X	Neonatal-Perinatal Medicine Physician	2005030231	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043219603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY DAWN ERNST M.D.

Provider Business Mailing Address
First Line	:	1200 EVERETT DR
Second Line	:	7TH FLOOR NORTH PAVILION, DIV OF NEONATOLOGY
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5047
Country	:	US
Telephone Number	:	405-271-5215
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 EVERETT DR
Second Line	:	7TH FLOOR NORTH PAVILION, DIV OF NEONATOLOGY
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5047
Country	:	US
Telephone Number	:	405-271-5215
Fax Number	:

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

Provider Enumeration Date	:	07/17/2005
Last Update Date	:	08/06/2011

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