Stover, Kimberly Carlson

Stover, Kimberly Carlson is an individual health care provider with primary practice located at 3190 Clearwater Dr , Prescott AZ 86305-7131. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Stover, Kimberly Carlson can be contacted via phone (928) 541-1312.

Contact Information

Primary practice address
3190 Clearwater Dr Prescott AZ 86305-7131
Fax: (928) 541-0002
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN148475 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP2910 Arizona

Profile Details

NPI number 1285817122
LBN Legal business name Stover, Kimberly Carlson
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2007
Last updated Jan 3rd, 2019 - about 5 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 1285817122 NPPES
Arizona MEDICAID 527011

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