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Individual

KIMBERLY C PENDLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
480 HOPKINSVILLE ST, GREENVILLE, KY 42345-1124
(270) 338-5777
(270) 338-5765
Mailing address
480 HOPKINSVILLE ST, GREENVILLE, KY 42345-1124
(270) 338-5777
(270) 338-5765

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5984P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000614011
ANTHEM BCBS
KY
05
7100082690
KY
Enumeration date
04/09/2009
Last updated
12/20/2019
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