Individual
KIMBERLY S BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15209
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215207451
—
NC
05
—
1527812
—
TN
05
—
7100195690
—
KY
05
—
7100195690
—
VA
01
—
P01200424
RAILROAD MEDICARE PIN
TN
Enumeration date
01/05/2012
Last updated
01/26/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us