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NPI Code Detail

MEDICARE: KIMBERLY GODWIN MCPHERSON FNP

MEDICARE: KIMBERLY GODWIN MCPHERSON FNP
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 Practitioner5012739NC

General Provider Information

NPI Number : 1558991919
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY GODWIN MCPHERSON FNP
Provider Business Mailing Address
First Line : 823 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3703
Country : US
Telephone Number : 910-642-6121
Fax Number :
Provider Business Practice Location Address
First Line : 823 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3703
Country : US
Telephone Number : 910-642-6121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2020
Last Update Date : 01/23/2020

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Directions to “ KIMBERLY GODWIN MCPHERSON FNP” Practice Location

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