Donelson, Kimberly

Donelson, Kimberly is an individual health care provider with primary practice located at 1501 Kings Hwy Department Of Pediatrics, Shreveport LA 71103-4228. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Donelson, Kimberly can be contacted via phone (318) 675-6093.

Contact Information

Primary practice address
1501 Kings Hwy Department Of Pediatrics Shreveport LA 71103-4228
Phone: (318) 675-6093
Fax: (318) 675-8832
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN089397 AP05554 Louisiana

Profile Details

NPI number 1750537767
LBN Legal business name Donelson, Kimberly
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2008
Last updated Oct 14th, 2011 - about 14 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 1750537767 NPPES
Louisiana Other 3A776F600 MEDICARE - PTAN
Louisiana MEDICAID 1316865 MEDICARE - PTAN

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