Proctor, Kimberly E
Proctor, Kimberly E is an individual health care provider with primary practice located at 332 N Lauderdale St. Ms 133, Memphis TN 38105-2794. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Proctor, Kimberly E can be contacted via phone (901) 495-3006.Contact Information
Primary practice address
332 N Lauderdale St. Ms 133
Memphis TN 38105-2794
Phone: (901) 495-3006
Fax: (901) 495-3842
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 97240 | Tennessee |
Profile Details
| NPI number | 1609853381 |
|---|---|
| LBN Legal business name | Proctor, Kimberly E |
| Credentials | RN/NP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 23rd, 2005 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609853381 | NPPES |
| Tennessee | MEDICAID | 5440513 |
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