Provider Demographics
NPI:1912015678
Name:ADAMS-MCDARTY, KIMBERLEY A (ARNP RN)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:A
Last Name:ADAMS-MCDARTY
Suffix:
Gender:F
Credentials:ARNP RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E 6TH AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-3144
Mailing Address - Country:US
Mailing Address - Phone:202-221-4000
Mailing Address - Fax:620-221-7121
Practice Address - Street 1:1230 E 6TH AVE STE 1B
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-3144
Practice Address - Country:US
Practice Address - Phone:620-221-4000
Practice Address - Fax:620-221-7121
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSRN1483930052363L00000X
KSARNP44996363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161332OtherBLUE SHIELD
KS200266970AMedicaid
KS4347S0OtherFIRSTGUARD
KS161332OtherBLUE SHIELD