Individual
MRS. KIMBERLY EILEEN CREDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, RD, LD
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 389-2150
(706) 389-2151
Mailing address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 389-2150
(706) 389-2151
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
LD002413
GA
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN185977
GA
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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