Wilson, Kimberly Shannon

Wilson, Kimberly Shannon is an sole proprietor health care provider with primary practice located at 5401 Kingston Pike Ste 170, Knoxville TN 37919-5022. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Wilson, Kimberly Shannon can be contacted via phone (865) 584-4005.

Contact Information

Primary practice address
5401 Kingston Pike Ste 170 Knoxville TN 37919-5022
Phone: (865) 584-4005
Fax: (865) 584-5551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X P0000002498 Tennessee

Profile Details

NPI number 1316091119
LBN Legal business name Wilson, Kimberly Shannon
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Aug 17th, 2015 - about 9 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 1316091119 NPPES
Tennessee MEDICAID 3983201

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