Provider Demographics
NPI:1649840463
Name:DUNCAN, KIMBERLY LATRICE (FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LATRICE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LATRICE
Other - Last Name:SPEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1811 GRAND RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1270
Mailing Address - Country:US
Mailing Address - Phone:205-209-8523
Mailing Address - Fax:
Practice Address - Street 1:800 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35229-0002
Practice Address - Country:US
Practice Address - Phone:205-726-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-142682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily