Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 08002327A | IN |
Y | 111NN1001X | Nutrition | 2414 | TN |
NPI | 1346428620 |
---|---|
Provider Name | Dr. Kimberly Gerbers Brengle |
First Address | Franklin, TN 37069-4204 |
Second Address | Franklin, TN 37069-4204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 03/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
KG 1008 | (02) | TN |