Individual
KIMBERLEY B WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6671
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6000
(423) 433-6140
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
96882
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05/25/1970
DATE OF BIRTH
—
05
—
1520893
—
TN
Enumeration date
04/28/2006
Last updated
05/11/2026
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