Individual
MRS. AMANDA DENISE KIMBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
318 S 7TH ST, MAYFIELD, KY 42066-2337
(270) 251-3223
(270) 251-3220
Mailing address
318 S 7TH ST, MAYFIELD, KY 42066-2337
(270) 251-3223
(270) 251-3220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007992
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00975
MEDICARE GROUP
KY
01
—
1122485
NURSE
KY
01
—
253582
COVENTRY--MEDICAID
KY
01
—
3007992
APRN LIC
KY
01
—
7100090880
MEDICAID GROUP
KY
05
—
7100242550
—
KY
Enumeration date
03/11/2013
Last updated
03/07/2023
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