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Individual
KIMBERLIE A VOSBURGH
Active
Individual
KIMBERLIE A VOSBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-01684
KS
363A00000X
Physician Assistant
Primary
3096
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002428
MEDICARE PTAN
KS
05
—
201092230B
—
KS
Enumeration date
03/17/2014
Last updated
10/22/2019
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