Provider Demographics
NPI:1790499069
Name:SENDERS, KIMBERLY ANN (RN-BSN, NP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:SENDERS
Suffix:
Gender:F
Credentials:RN-BSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:IN
Mailing Address - Zip Code:46542-3006
Mailing Address - Country:US
Mailing Address - Phone:574-832-6246
Mailing Address - Fax:574-832-2001
Practice Address - Street 1:112 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IN
Practice Address - Zip Code:46542-3006
Practice Address - Country:US
Practice Address - Phone:574-832-6246
Practice Address - Fax:574-832-2001
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28162151A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily