Provider Demographics
NPI:1326635392
Name:DOBBYN, KIMBERLY (APN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:DOBBYN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 BUFFETT PKWY
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3567
Mailing Address - Country:US
Mailing Address - Phone:317-695-1904
Mailing Address - Fax:
Practice Address - Street 1:8750 BUFFETT PKWY
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3567
Practice Address - Country:US
Practice Address - Phone:317-695-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28203918A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily