Provider Demographics
NPI:1972517399
Name:FOUSHEE, KIMBERLY RENEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:RENEE
Last Name:FOUSHEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9127 FERN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-2711
Mailing Address - Country:US
Mailing Address - Phone:502-239-0013
Mailing Address - Fax:502-239-0984
Practice Address - Street 1:9127 FERN CREEK RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-2711
Practice Address - Country:US
Practice Address - Phone:502-239-0013
Practice Address - Fax:502-239-0984
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY64431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics