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:
Health care specialties
| Specialty | Code | License # | 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 4 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 | 1013359934 | NPPES |
| Other | 1799G | BCBS | |
| Other | Q44206A | BCBS | |
| MEDICAID | 1013359934 | BCBS |
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