Provider Demographics
NPI:1811123680
Name:KIMSEY, ELIZABETH ANNE (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:KIMSEY
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11505 RANGELAND PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-9504
Mailing Address - Country:US
Mailing Address - Phone:941-362-8644
Mailing Address - Fax:941-362-8602
Practice Address - Street 1:11505 RANGELAND PKWY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-9504
Practice Address - Country:US
Practice Address - Phone:941-362-8644
Practice Address - Fax:941-362-8602
Is Sole Proprietor?:No
Enumeration Date:2009-06-06
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9173056363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY07Z1OtherFL BLUE CROSS/BLUE SHIELD
FLY07Z1OtherFL BLUE CROSS/BLUE SHIELD