Provider Demographics
NPI:1639764079
Name:MARKGRAF, KIMBERLY ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:MARKGRAF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 JOHN SHARPE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:TN
Mailing Address - Zip Code:38461-5019
Mailing Address - Country:US
Mailing Address - Phone:731-549-0770
Mailing Address - Fax:
Practice Address - Street 1:160 JOHN SHARPE RD
Practice Address - Street 2:
Practice Address - City:HAMPSHIRE
Practice Address - State:TN
Practice Address - Zip Code:38461-5019
Practice Address - Country:US
Practice Address - Phone:731-549-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000029106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily