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NPI Code Detail

MEDICARE: MRS. KIMBERLY LUANN WEBB DRIVER CRNP

MEDICARE: MRS. KIMBERLY LUANN WEBB DRIVER CRNP
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
1363LF0000XFamily Nurse Practitioner1-121113AL
2363LF0000XFamily Nurse PractitionerRN183530GA

General Provider Information

NPI Number : 1538450598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY LUANN WEBB DRIVER CRNP
Provider Business Mailing Address
First Line : 736 W BANKHEAD HWY
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-1501
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 736 W BANKHEAD HWY
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-1501
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2011
Last Update Date : 07/21/2022

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