Pendleton, Kimberly C

Pendleton, Kimberly C is an individual health care provider with primary practice located at 1009 Lark St Suite 2, Johnson City TN 37604-8217. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Pendleton, Kimberly C can be contacted via phone (423) 283-0776.

Contact Information

Primary practice address
1009 Lark St Suite 2 Johnson City TN 37604-8217
Phone: (423) 283-0776
Fax: (423) 283-0549
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN0000049997 Tennessee

Profile Details

NPI number 1215920376
LBN Legal business name Pendleton, Kimberly C
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated May 9th, 2013 - about 11 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 1215920376 NPPES
Tennessee MEDICAID 3602812

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