Individual
MRS. KIMBERLY KAY SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRN FIRST ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
40474
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126752000
—
WV
05
—
0126874000
—
WV
05
—
0127488000
—
WV
05
—
0127974000
—
WV
05
—
3810011004
—
WV
Enumeration date
12/05/2006
Last updated
11/04/2009
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