MEDICARE: MS. KIMBERLY H SOWDEN ARNP

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	363L00000X	Nurse Practitioner	3005140	KY

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
2	1234437	OTHER	KY	CHA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000517138	OTHER	KY	BLUE CROSS AND BLUE SHIELD

General Provider Information

NPI Number	:	1376686105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY H SOWDEN ARNP

Provider Business Mailing Address
First Line	:	2161 LEXINGTON RD
Second Line	:	1ST FLOOR, SUITE 5
City	:	RICHMOND
State	:	KY
Zip	:	40475-7952
Country	:	US
Telephone Number	:	859-626-7794
Fax Number	:	859-626-4420

Provider Business Practice Location Address
First Line	:	2161 LEXINGTON RD
Second Line	:	1ST FLOOR SUITE 5
City	:	RICHMOND
State	:	KY
Zip	:	40475-7952
Country	:	US
Telephone Number	:	859-626-7794
Fax Number	:	859-626-4420

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	02/01/2016

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