Individual
KIMBERLY PAIGE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
218 INDIAN CREEK RD, JACKSBORO, TN 37757-3018
(423) 494-6300
(423) 377-1110
Mailing address
218 INDIAN CREEK RD, JACKSBORO, TN 37757-3018
(423) 494-6300
(423) 377-1110
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000064207
TN
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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