Individual
KIMBERLY S HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
141 N EAGLE CREEK DR STE 200, LEXINGTON, KY 40509-2538
(859) 543-1000
(859) 543-0399
Mailing address
141 N. EAGLE CREEK DRIVE, SUITE 200, LEXINGTON, KY 40509
(859) 266-2273
(859) 266-2274
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA736
KY
363AM0700X
Medical Physician Assistant
PA736
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100051870
—
KY
Enumeration date
01/19/2007
Last updated
11/18/2013
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