Individual
LAURA N KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
482 INTERSTATE DR, MANCHESTER, TN 37355-3485
(931) 728-4718
Mailing address
481 INTERSTATE DR, MANCHESTER, TN 37355-3108
(931) 728-6354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
34831
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34831
STATE LICENSE
TN
Enumeration date
10/18/2023
Last updated
08/21/2024
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