Provider Demographics
NPI:1871640516
Name:NOLEN, KIMBERLY NORMAN (OT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:NORMAN
Last Name:NOLEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 KATE BOND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4004
Mailing Address - Country:US
Mailing Address - Phone:901-937-3200
Mailing Address - Fax:901-383-1738
Practice Address - Street 1:3045 KATE BOND RD STE 200
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-4004
Practice Address - Country:US
Practice Address - Phone:901-937-3200
Practice Address - Fax:901-383-1738
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN220225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand