Provider Demographics
NPI:1891782702
Name:SETSER, KIMBERLY MESCHELYN (FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MESCHELYN
Last Name:SETSER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 HIGHWAY 107 S
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TN
Mailing Address - Zip Code:37727-2654
Mailing Address - Country:US
Mailing Address - Phone:423-623-3100
Mailing Address - Fax:423-839-0356
Practice Address - Street 1:260 HIGHWAY 107 S
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TN
Practice Address - Zip Code:37727-2654
Practice Address - Country:US
Practice Address - Phone:423-623-3100
Practice Address - Fax:423-815-1250
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3929172Medicaid
TN3929172Medicare ID - Type Unspecified
TN3929172Medicaid