Logan, Kimber Janine
Logan, Kimber Janine is an sole proprietor health care provider with primary practice located at 315 N Washington Ave Suite 175, Cookeville TN 38501-2603. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Logan, Kimber Janine can be contacted via phone (931) 528-3300.Contact Information
Primary practice address
315 N Washington Ave Suite 175
Cookeville TN 38501-2603
Phone: (931) 528-3300
Fax: (931) 372-2102
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1569 | Tennessee |
Profile Details
| NPI number | 1467637736 |
|---|---|
| LBN Legal business name | Logan, Kimber Janine |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 7th, 2008 |
| Last updated | Sep 14th, 2016 - about 10 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 | 1467637736 | NPPES |
| Tennessee | MEDICAID | 3665193 | |
| Tennessee | Other | 621307839 |
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