# KIMALISA KAY SHAMBLIN

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

## Provider details

- **NPI number:** 1982909800
- **Gender:** F
- **Credential:** BA, RT(R)(CT), RVT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246XS1301X | Sonography Specialist/Technologist Cardiovascular | 1540 | WV | — |
| 247100000X | Radiologic Technologist | 1540 | WV | — |
| 2471C3401X | Computed Tomography Radiologic Technologist | 1540 | WV | Yes |
| 2471C3402X | Radiography Radiologic Technologist | 1540 | WV | — |
| 2471S1302X | Sonography Radiologic Technologist | 1540 | WV | — |
| 2471V0105X | Vascular Sonography Radiologic Technologist | 1540 | WV | — |

## Other

- **Enumeration date:** 01/25/2011
- **Last updated:** 01/25/2011