Individual
KIM A ANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1211 21ST AVE S, 220 MEDICAL ARTS BUILDING, NASHVILLE, TN 37232-2702
(615) 322-0128
(615) 936-6977
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2346
TN
363AM0700X
Medical Physician Assistant
Primary
2346
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q003409
—
TN
Enumeration date
08/09/2006
Last updated
03/23/2022
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