Provider Demographics
NPI:1710294319
Name:DAMRON, KIMBERLY PAIGE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:PAIGE
Last Name:DAMRON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:MCINNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:790 SE CARY PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5678
Mailing Address - Country:US
Mailing Address - Phone:919-784-7400
Mailing Address - Fax:919-784-7405
Practice Address - Street 1:790 SE CARY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5678
Practice Address - Country:US
Practice Address - Phone:919-784-7400
Practice Address - Fax:919-784-7405
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAZ583231H00000X
NC13859237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter