Sargent, Kimball Jane-Marie
Sargent, Kimball Jane-Marie is an sole proprietor health care provider with primary practice located at 7155 Sunset Lake Rd , Fuquay Varina NC 27526-8638. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult is her primary health care specialty. Sargent, Kimball Jane-Marie can be contacted via phone (919) 838-0804.Contact Information
Primary practice address
7155 Sunset Lake Rd
Fuquay Varina NC 27526-8638
Phone: (919) 838-0804
Fax: (919) 838-1219
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 080028 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 364SP0808X | 080028 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult | 364SP0809X | 0261495-01 | North Carolina |
Profile Details
| NPI number | 1174570808 |
|---|---|
| LBN Legal business name | Sargent, Kimball Jane-Marie |
| Credentials | MSN, PMHCNS-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 28th, 2006 |
| Last updated | Jan 13th, 2019 - about 7 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 | 1174570808 | NPPES |
| North Carolina | Other | 10079 | BCBS PROVIDER # |
| North Carolina | Other | 527619 | BCBS PROVIDER # |
| North Carolina | MEDICAID | 6004025 | BCBS PROVIDER # |
| North Carolina | Other | 232289 | BCBS PROVIDER # |
| North Carolina | Other | C 2802004 | BCBS PROVIDER # |
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