MEDICARE: MRS. KIMBERLY LORRAINE MCMURTREY DNP, APRN, FNP-C

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	18009	TN

General Provider Information

NPI Number	:	1528209269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY LORRAINE MCMURTREY DNP, APRN, FNP-C

Provider Business Mailing Address
First Line	:	154 W SPRINGBROOK DR
Second Line	:	SUITE 154
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-1758
Country	:	US
Telephone Number	:	423-975-6656
Fax Number	:	423-975-6657

Provider Business Practice Location Address
First Line	:	154 W SPRINGBROOK DR
Second Line	:	SUITE 154
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-1758
Country	:	US
Telephone Number	:	423-975-6656
Fax Number	:	423-975-6657

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

Provider Enumeration Date	:	03/10/2009
Last Update Date	:	10/21/2015

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