Mrs. Kimberly Randall Booker
Nurse Practitioner - Women's Health
520 Maple Ave Suite C
Reidsville
, North Carolina 27320-4652
Mrs. Kimberly Randall Booker
Nurse Practitioner - Women's Health
520 Maple Ave Suite C
Reidsville
, North Carolina 27320-4652
(336) 613-0904
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Mrs. Kimberly Randall Booker
- 3871 Vance Street Ext
- Reidsville, NC
- Zip : 27320-8873
- Phone : (336) 613-0904
Second Address
- Mrs. Kimberly Randall Booker
- 520 Maple Ave Suite C
- Reidsville, NC
- Zip : 27320-4652
- Fax : (336) 342-6066
- Phone : (336) 342-6063
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363LW0102X | Nurse Practitioner - Women's Health | BOO104379455 | NC |
National Provider Identifier
| NPI | 1013359934 |
|---|---|
| Provider Name | Mrs. Kimberly Randall Booker |
| First Address | Reidsville, NC 27320-8873 |
| Second Address | Reidsville, NC 27320-4652 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/07/2013 |
| Last Update Date | 11/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1013359934 | (05) | NC |
| 1799G | BCBS (01) | |
| Q44206A | MEDICARE INDIVIDUAL PTAN LINKED TO FACULTY PRACTICE GROUP (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.