Booker, Kimberly Randall

Booker, Kimberly Randall is an individual health care provider with primary practice located at 520 Maple Ave Suite C, Reidsville NC 27320-4652. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Booker, Kimberly Randall can be contacted via phone (336) 342-6063.

Contact Information

Primary practice address
520 Maple Ave Suite C Reidsville NC 27320-4652
Phone: (336) 342-6063
Fax: (336) 342-6066
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X BOO104379455 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 522 North Carolina

Profile Details

NPI number 1013359934
LBN Legal business name Booker, Kimberly Randall
Credentials CNM, WHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2013
Last updated Aug 11th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013359934 NPPES
Other 1799G BCBS
Other Q44206A BCBS
MEDICAID 1013359934 BCBS

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