Provider Demographics
NPI:1972825545
Name:GERMAN, KIMBERLY LEIGH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LEIGH
Last Name:GERMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-0055
Mailing Address - Country:US
Mailing Address - Phone:870-733-1177
Mailing Address - Fax:870-702-6128
Practice Address - Street 1:1120 STATE HIGHWAY 77 STE 1
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-9046
Practice Address - Country:US
Practice Address - Phone:870-733-1177
Practice Address - Fax:870-702-6128
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14015363LF0000X
ARATP 236363LF0000X
MSR870228163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse