Provider Demographics
NPI:1629352331
Name:SMITH, KIMBERLY D (B S)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:SMITH
Suffix:
Gender:F
Credentials:B S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COUNTY SERVICES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1748
Mailing Address - Country:US
Mailing Address - Phone:615-463-6166
Mailing Address - Fax:615-463-6616
Practice Address - Street 1:162 COUNTY SERVICES RD STE 100
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1748
Practice Address - Country:US
Practice Address - Phone:615-463-6166
Practice Address - Fax:615-463-6616
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator