Logan, Kimberly A

Logan, Kimberly A is an individual health care provider with primary practice located at 63 State Road , Gt Barrington MA 01230-1223. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Logan, Kimberly A can be contacted via phone (413) 644-9933.

Contact Information

Primary practice address
63 State Road Gt Barrington MA 01230-1223
Phone: (413) 644-9933
Fax: (413) 644-9433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 210360 Massachusetts

Profile Details

NPI number 1700931342
LBN Legal business name Logan, Kimberly A
Credentials FNPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2007
Last updated Oct 27th, 2010 - about 14 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 1700931342 NPPES
Massachusetts MEDICAID 0799017

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