Individual
KIMBERLY S KERSHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1235 E CHEROKEE ST, SUITE 2B, SPRINGFIELD, MO 65804-2203
(417) 820-3064
(417) 820-8862
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
146907
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407160013
—
MO
05
—
183615758
—
AR
01
—
431560263
TRICARE WEST
—
Enumeration date
08/06/2010
Last updated
10/14/2010
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