Provider Demographics
NPI:1275290231
Name:ADAMS, KIMBERLY ANN EWELL (FNP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN EWELL
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN EWELL
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3121 MOSELEY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4245
Mailing Address - Country:US
Mailing Address - Phone:252-758-4455
Mailing Address - Fax:252-758-6742
Practice Address - Street 1:101 HEART DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8982
Practice Address - Country:US
Practice Address - Phone:252-744-4611
Practice Address - Fax:252-816-0762
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily