Provider Demographics
NPI:1669236105
Name:SAUNDERS, KIMBERLEE KAY (AGPCNP)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:KAY
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 TANIERE CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6146
Mailing Address - Country:US
Mailing Address - Phone:269-599-7270
Mailing Address - Fax:
Practice Address - Street 1:301 HALTON RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3496
Practice Address - Country:US
Practice Address - Phone:864-962-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28345363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner