Provider Demographics
NPI:1659476240
Name:ENGLISH, KIM RENAE (MSN, FNP, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:RENAE
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:MSN, FNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 LATROBE DR STE 850B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4827
Mailing Address - Country:US
Mailing Address - Phone:980-445-8063
Mailing Address - Fax:
Practice Address - Street 1:3719 LATROBE DR STE 850B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4827
Practice Address - Country:US
Practice Address - Phone:980-445-8063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC198881163WC1500X
NC5004910363LF0000X
NC2020114621363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily