Individual
KIMBERLY VANERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 WYNNTON RD STE 201, COLUMBUS, GA 31906-2574
(762) 241-0681
Mailing address
2210 WYNNTON RD STE 201, COLUMBUS, GA 31906-2574
(762) 241-0681
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60638
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372013800
—
GA
Enumeration date
12/10/2021
Last updated
12/10/2021
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