Grant, Kimberly Gilliam

Grant, Kimberly Gilliam is an individual health care provider with primary practice located at 6107 N 1St St Ste 103 , Fresno CA 93710-5460. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Grant, Kimberly Gilliam can be contacted via phone (559) 432-4963.

Contact Information

Primary practice address
6107 N 1St St Ste 103 Fresno CA 93710-5460
Phone: (559) 432-4963
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA642 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 9109580 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X TL1232 South Carolina

Profile Details

NPI number 1871569855
LBN Legal business name Grant, Kimberly Gilliam
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated May 6th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871569855 NPPES
South Carolina MEDICAID 0576APA

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