Individual
KIMBERLY HAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6901 SIMMONS LOOP, RIVERVIEW, FL 33578-9498
(813) 302-8400
Mailing address
2322 DAKOTA ROCK DR, RUSKIN, FL 33570-6380
(813) 610-9695
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9345319
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN9345319
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
10/29/2018
Last updated
10/29/2018
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