Provider Demographics
NPI:1568854198
Name:MCCORKLE, KIMBERLY KATE (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:KATE
Last Name:MCCORKLE
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 1:501 JONES FERRY RD APT K4
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2118
Mailing Address - Country:US
Mailing Address - Phone:919-358-6518
Mailing Address - Fax:
Practice Address - Street 1:501 JONES FERRY RD APT K4
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2118
Practice Address - Country:US
Practice Address - Phone:919-358-6518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor