Provider Demographics
NPI:1669162061
Name:KIMBLEY, MEGAN MARIE (PA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:KIMBLEY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4665 N US HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8558
Mailing Address - Country:US
Mailing Address - Phone:123-769-3538
Mailing Address - Fax:
Practice Address - Street 1:4665 N US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-8558
Practice Address - Country:US
Practice Address - Phone:812-376-9353
Practice Address - Fax:812-376-3757
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2025-05-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant