Provider Demographics
NPI:1013603307
Name:ECHEVARRIA, KIMBERLY (FNP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:ECHEVARRIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2789 BELL PORT AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7561
Mailing Address - Country:US
Mailing Address - Phone:559-972-9681
Mailing Address - Fax:
Practice Address - Street 1:3130 W CALDWELL AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7063
Practice Address - Country:US
Practice Address - Phone:559-635-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily