Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 2005030231 | MO |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 23319 | OK |
NPI | 1043219603 |
---|---|
Provider Name | Dr. Kimberly Dawn Ernst |
First Address | Oklahoma City, OK 73104-5047 |
Second Address | Oklahoma City, OK 73104-5047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2005 |
Last Update Date | 06/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200010070A | (05) | OK |
I06459 | (02) |