Cecil-Riddle, Kimberly

Cecil-Riddle, Kimberly is an sole proprietor health care provider with primary practice located at 2801 Walter Garrett Lane , Oak Grove KY 42262. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Cecil-Riddle, Kimberly can be contacted via phone (270) 640-5821.

Contact Information

Primary practice address
2801 Walter Garrett Lane Oak Grove KY 42262
Phone: (270) 640-5821
Fax: (844) 270-5587
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3004526 Kentucky

Profile Details

NPI number 1215171251
LBN Legal business name Cecil-Riddle, Kimberly
Credentials DNP, APRN, FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 21st, 2009
Last updated Jul 19th, 2016 - about 8 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 1215171251 NPPES
Tennessee MEDICAID Q020269
Tennessee Other K202700
Tennessee Other 474415234
Tennessee MEDICAID 7100395690
Tennessee Other K202701

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