Individual
KIMBERLY CARLSON STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3190 CLEARWATER DR, PRESCOTT, AZ 86305-7131
(928) 541-1312
(928) 541-0002
Mailing address
PO BOX 11208, PRESCOTT, AZ 86304-1208
(928) 541-1312
(928) 541-0002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN148475
AZ
363L00000X
Nurse Practitioner
Primary
AP2910
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
527011
—
AZ
Enumeration date
12/13/2007
Last updated
01/03/2019
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