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Individual
KIMBERLY DONELSON
Active
Individual
KIMBERLY DONELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN089397 AP05554
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316865
—
LA
01
—
3A776F600
MEDICARE - PTAN
LA
Enumeration date
08/09/2008
Last updated
10/14/2011
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