Provider Demographics
NPI:1245601525
Name:QUARLES, KIMBERLY (RN, MSN-ED)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:QUARLES
Suffix:
Gender:F
Credentials:RN, MSN-ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MISTYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-2865
Mailing Address - Country:US
Mailing Address - Phone:434-987-1228
Mailing Address - Fax:
Practice Address - Street 1:101 MISTYWOOD RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-2865
Practice Address - Country:US
Practice Address - Phone:434-987-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001193208174H00000X, 163W00000X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical