Provider Demographics
NPI:1659407286
Name:ALTERS, KIMBERLY MAXINE (DC/ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MAXINE
Last Name:ALTERS
Suffix:
Gender:F
Credentials:DC/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7890 SUMMERLIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1851
Mailing Address - Country:US
Mailing Address - Phone:239-590-3883
Mailing Address - Fax:239-590-3884
Practice Address - Street 1:7890 SUMMERLIN LAKES DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1851
Practice Address - Country:US
Practice Address - Phone:239-590-3883
Practice Address - Fax:239-590-3884
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1670952363L00000X
FLCH5200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT85531Medicare UPIN