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Individual
MS. KIMBERLY LYNN FUNCHESS
Active
Individual
MS. KIMBERLY LYNN FUNCHESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3343
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
985608
—
AZ
01
—
PA60322657
WASHINGTON STATE LICENSE
WA
Enumeration date
01/19/2006
Last updated
02/14/2019
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