Provider Demographics
NPI:1518924828
Name:HAVAS, KIM (NP)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HAVAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3737 GOVERNMENT BLVD
Mailing Address - Street 2:STE 408
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-4308
Mailing Address - Country:US
Mailing Address - Phone:251-602-1911
Mailing Address - Fax:251-602-1850
Practice Address - Street 1:3737 GOVERNMENT BLVD
Practice Address - Street 2:STE 408
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4308
Practice Address - Country:US
Practice Address - Phone:251-602-1911
Practice Address - Fax:251-602-1850
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA158753 NP363LA2200X
AL1-053137363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health