Provider Demographics
NPI:1437486057
Name:CHALOT, KIMBERLY JONES (NP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JONES
Last Name:CHALOT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LUKE ST STE D
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-9680
Mailing Address - Country:US
Mailing Address - Phone:252-337-9440
Mailing Address - Fax:252-384-9997
Practice Address - Street 1:701 LUKE ST STE D
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-9680
Practice Address - Country:US
Practice Address - Phone:252-337-9440
Practice Address - Fax:252-384-9997
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004519363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner