Individual
KIMBERLY DAWN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
512 SAFFELL ST, LAWRENCEBURG, KY 40342-1253
(502) 227-2229
(502) 227-1114
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1693
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008104
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700172
STATE LICENSE
KY
05
—
7100017280
—
KY
Enumeration date
06/30/2013
Last updated
06/10/2021
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