Provider Demographics
NPI:1619417714
Name:KIMBER, ALISHA (FNP)
Entity Type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:
Last Name:KIMBER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-5041
Mailing Address - Country:US
Mailing Address - Phone:901-222-9837
Mailing Address - Fax:
Practice Address - Street 1:814 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-5041
Practice Address - Country:US
Practice Address - Phone:901-222-9837
Practice Address - Fax:901-222-9855
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily