Provider Demographics
NPI:1245299783
Name:KIMBLE-HAHN, JO ANN (FNP, MSN)
Entity type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:
Last Name:KIMBLE-HAHN
Suffix:
Gender:F
Credentials:FNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 HAHN SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:NC
Mailing Address - Zip Code:28124-9361
Mailing Address - Country:US
Mailing Address - Phone:704-436-8378
Mailing Address - Fax:
Practice Address - Street 1:3000 HAHN SCOTT RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:NC
Practice Address - Zip Code:28124-9361
Practice Address - Country:US
Practice Address - Phone:704-436-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201239363LF0000X
NC147795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily