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:
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Health care specialties

SpecialtyCodeLicense #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 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 1467637736 NPPES
Tennessee MEDICAID 3665193
Tennessee Other 621307839

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