Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | E-7881 | AR |
Y | 207Q00000X | Family Doctor | MD0000050418 | TN |
NPI | 1003128893 |
---|---|
Provider Name | Dr. Kimberly Lynn Pickett |
First Address | Chattanooga, TN 37411-5310 |
Second Address | Chattanooga, TN 37411-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2010 |
Last Update Date | 13/02/2014 |