Individual
TERRI KIMBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 275-5352
(812) 275-1374
Mailing address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 275-5352
(812) 275-1374
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000989B
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000989
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000307493
ANTHEM PROVIDER #
IN
05
—
200224680A
—
IN
Enumeration date
09/08/2005
Last updated
12/17/2020
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