Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 16537 | TN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 16537 | TN |
NPI | 1982977294 |
---|---|
Provider Name | Kimberly Lynn Chambers |
First Address | Maryville, TN 37804-4419 |
Second Address | Maryville, TN 37804-6205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 17/03/2018 |