Provider Demographics
NPI:1972645075
Name:BLAND, KIMBERLY (WHNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:BLAND
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5247 ST. IVES DR.
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MTSU -MCFARLAND STUDENT HEALTH SERVICES
Practice Address - Street 2:1301 EAST MAIN ST.
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37132-0001
Practice Address - Country:US
Practice Address - Phone:615-904-8402
Practice Address - Fax:615-494-7757
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11165363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health