Individual
DR. KIMBERLY JANE RICHMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
2205 GREENTREE N, CLARKSVILLE, IN 47129-8957
(812) 218-6560
(812) 288-2605
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3107563
KY
363LF0000X
Family Nurse Practitioner
71012567A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3017563
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71012567A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300071015
—
IN
01
—
3017563
STATE LICENSE
KY
05
—
7100806470
—
KY
01
—
71012567A
STATE LICENSE
IN
Enumeration date
03/22/2022
Last updated
12/04/2024
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