Individual
KIMBERLY DAWN WALSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1041 E SULLIVAN ST, KINGSPORT, TN 37660
(423) 224-1600
Mailing address
1041 E SULLIVAN ST, KINGSPORT, TN 37660
(423) 224-1600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000065318
TN
Other
Enumeration date
09/04/2007
Last updated
12/03/2007
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