Provider Demographics
NPI:1952325516
Name:ALKIRE, KIMBERLY JOHNSON (NP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JOHNSON
Last Name:ALKIRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3010 FARROW RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-7607
Mailing Address - Country:US
Mailing Address - Phone:803-434-1210
Mailing Address - Fax:803-434-1212
Practice Address - Street 1:1301 TAYLOR STREET
Practice Address - Street 2:SUITE 4-K
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2950
Practice Address - Country:US
Practice Address - Phone:803-765-2090
Practice Address - Fax:803-765-0580
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2986363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2986OtherLICENSE NUMBER