Individual
KIMBERLEY PRATER
Active
Individual
KIMBERLEY PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36418
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116201001
—
AR
01
—
1256
BLUE
MO
05
—
202564407
—
MO
01
—
300035139
RRR MEDICARE
MO
01
—
P00807644
MEDICARE RAILROAD
MO
Enumeration date
03/27/2006
Last updated
06/03/2010
Update your record
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