Individual
MRS. KIMBERLY JILL SHIBAYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4230 HARDING RD, SUITE 1000, NASHVILLE, TN 37205-2013
(615) 383-2693
Mailing address
PO BOX 105132, ATLANTA, GA 30348-5132
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA1187
TN
363AS0400X
Surgical Physician Assistant
Primary
PA1187
TN
Other
Enumeration date
10/24/2005
Last updated
01/20/2010
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