Individual
MRS. MELISSA BLAIR KIMBRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
575 INGLES DR, INMAN, SC 29349-8314
(864) 342-4090
(864) 578-7098
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19733
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3586
—
SC
01
—
SC70476067
MEDICARE PIN
SC
01
—
SC70476084
MEDICARE PIN
SC
01
—
SC7047J577
MEDICARE PIN
SC
Enumeration date
09/14/2015
Last updated
02/27/2020
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