Wilmoth, Kimberly Anne
Wilmoth, Kimberly Anne is an individual health care provider with primary practice located at 1336 Highway 54 W , Fayetteville GA 30214-4535. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wilmoth, Kimberly Anne can be contacted via phone (770) 461-1238.Contact Information
Primary practice address
1336 Highway 54 W
Fayetteville GA 30214-4535
Phone: (770) 461-1238
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN122557 | Georgia |
Profile Details
| NPI number | 1679019020 |
|---|---|
| LBN Legal business name | Wilmoth, Kimberly Anne |
| Credentials | APRN, FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2017 |
| Last updated | Jun 2nd, 2017 - about 9 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 | 1679019020 | NPPES |
| Georgia | MEDICAID | 003187048B | |
| Georgia | MEDICAID | 003187048A |
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