Provider Demographics
NPI:1225247257
Name:WILLIAMS, KIMBERLEY D (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1213 E CLAY ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5071
Mailing Address - Country:US
Mailing Address - Phone:804-828-9956
Mailing Address - Fax:804-828-6662
Practice Address - Street 1:1213 E CLAY ST
Practice Address - Street 2:BOX 985912
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5071
Practice Address - Country:US
Practice Address - Phone:804-828-9956
Practice Address - Fax:804-828-6662
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024164533363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care