Randolph, Kimberly M

Randolph, Kimberly M is an individual health care provider with primary practice located at 3180 Professional Plz Ste 111, Germantown TN 38138-1534. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Randolph, Kimberly M can be contacted via phone (901) 854-5455.

Contact Information

Primary practice address
3180 Professional Plz Ste 111 Germantown TN 38138-1534
Phone: (901) 854-5455
Fax: (901) 861-7736
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 7234 Tennessee

Profile Details

NPI number 1144544982
LBN Legal business name Randolph, Kimberly M
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2010
Last updated Apr 1st, 2021 - about 3 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 1144544982 NPPES
Tennessee MEDICAID 1518380

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