Provider Demographics
NPI:1427366640
Name:DAWES, KIMBERLY NICELY (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:NICELY
Last Name:DAWES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:MARIE
Other - Last Name:NICELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:206 N THOMPSON LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-4332
Mailing Address - Country:US
Mailing Address - Phone:615-867-6700
Mailing Address - Fax:615-867-6788
Practice Address - Street 1:206 N THOMPSON LN
Practice Address - Street 2:SUITE B
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4332
Practice Address - Country:US
Practice Address - Phone:615-867-6700
Practice Address - Fax:615-867-6788
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor