# BONNELIA M KIMBLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912928862
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 3004268 | KY | Yes |
| 363L00000X | Nurse Practitioner | 4268P | KY | — |

## Other

- **Enumeration date:** 07/23/2006
- **Last updated:** 01/20/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000533456 | ANTHEM PIN | KY |
| 01 | — | 000000693047 | ANTHEM - NCVA | KY |
| 01 | — | 000057080V | HUMANA - NCVA | KY |
| 01 | — | 122023 | SIHO - NCVA | KY |
| 05 | — | 7100147010 | — | KY |
| 01 | — | P00992186 | RAILROAD MEDICARE - KY | KY |