Humphrey, Kimberlynn M

Humphrey, Kimberlynn M is an individual health care provider with primary practice located at 4326 Charlestown Rd # 2 , New Albany IN 47150-8542. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Humphrey, Kimberlynn M can be contacted via phone (812) 945-0023.

Contact Information

Primary practice address
4326 Charlestown Rd # 2 New Albany IN 47150-8542
Fax: (812) 945-0291
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18004172A Indiana

Profile Details

NPI number 1477114379
LBN Legal business name Humphrey, Kimberlynn M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2019
Last updated Jun 24th, 2019 - about 5 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 1477114379 NPPES
Indiana MEDICAID PENDING

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