Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APN0000020054 | TN |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN243783 | GA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN243783 | GA |
NPI | 1003298100 |
---|---|
Provider Name | Ms. Kimberly Erika Dowe |
First Address | Lawrenceville, GA 30045-3534 |
Second Address | Suwanee, GA 30024-2511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 04/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003194760H | (05) | GA |