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Individual

KIMBERLEY BRUMLEVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 776-8912

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28009
KY
208000000X
Pediatrics Physician
28009
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000308028
ANTHEM
KY
05
64076136
KY
Enumeration date
06/23/2005
Last updated
04/13/2021
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