Provider Demographics
NPI:1265058374
Name:DIEHL, KIMBERLY BAIER (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:BAIER
Last Name:DIEHL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LOVEJOY
Other - Last Name:BAIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-6810
Mailing Address - Fax:864-224-1109
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-6810
Practice Address - Fax:864-224-1109
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily