Individual
KATRINA M SHIMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, OMT
Contact information
Practice address
201 PIEDMONT ST #632, REIDSVILLE, NC 27320-3869
(717) 639-8996
Mailing address
201 PIEDMONT ST #632, REIDSVILLE, NC 27320-3869
(336) 496-1636
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
12153
NC
174400000X
Specialist
Primary
12153
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12153
SPECIALIST
NC
Enumeration date
12/19/2022
Last updated
12/20/2022
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