Individual
KIMBERLY MCCOY NUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Mailing address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7126
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1413R
BCBS
NC
01
—
4600072
UNITED HEALTHCARE
—
01
—
7153768
AETNA
—
05
—
7412507
—
NC
01
—
8300041
MEDICAID CBRS
NC
Enumeration date
12/22/2006
Last updated
07/08/2007
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