Provider Demographics
NPI:1942425731
Name:DEVOTIE, KIMBERLY HOPE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:HOPE
Last Name:DEVOTIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 DEVOTIE RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-4020
Mailing Address - Country:US
Mailing Address - Phone:865-475-0960
Mailing Address - Fax:865-397-1246
Practice Address - Street 1:931 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4701
Practice Address - Country:US
Practice Address - Phone:865-397-3930
Practice Address - Fax:865-397-1246
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000057852164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNLPN0000057852OtherMULTISTATE