Individual
KIMBERLY R HUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4248 MOUNT ZION RD, CARROLLTON, GA 30117-7602
(770) 836-0103
Mailing address
PO BOX 112, TEMPLE, GA 30179-0112
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN195261
GA
363LF0000X
Family Nurse Practitioner
Primary
RN195261
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN195261
LICENSE
GA
Enumeration date
06/19/2013
Last updated
04/08/2024
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