Provider Demographics
NPI:1346428620
Name:BRENGLE, KIMBERLY GERBERS (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:GERBERS
Last Name:BRENGLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 DAVENPORT DR STE 200B
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4204
Mailing Address - Country:US
Mailing Address - Phone:615-878-3485
Mailing Address - Fax:615-878-3485
Practice Address - Street 1:1109 DAVENPORT DR STE 200B
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-4204
Practice Address - Country:US
Practice Address - Phone:615-878-3485
Practice Address - Fax:615-878-3485
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2414111NN1001X
IN08002327A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNKG 1008Medicare UPIN