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Individual

MRS. KIMBERLY KAY BEVERLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
10331 CHAMPION FARMS DR, LOUISVILLE, KY 40241-6129
(216) 468-5000
(216) 456-8128
Mailing address
2904 N RYKERS RIDGE RD, MADISON, IN 47250-7648
(812) 701-1591

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
28134347A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4007045
KY

Other

Enumeration date
08/02/2019
Last updated
10/13/2023
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