Individual
EMILY L. KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-7728
(417) 269-7729
Mailing address
PO BOX 7411626, CHICAGO, IL 60674-5626
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2013021646
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220026436
—
MO
01
—
431560263
TRICARE
MO
01
—
P01222573
RR MCR
MO
Enumeration date
06/29/2013
Last updated
09/30/2025
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