Provider Demographics
NPI:1831928670
Name:SEYMORE, KIMBERLY KNOWLTON (AGPC-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KNOWLTON
Last Name:SEYMORE
Suffix:
Gender:
Credentials:AGPC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 COUNTY ROAD 66
Mailing Address - Street 2:
Mailing Address - City:ARLEY
Mailing Address - State:AL
Mailing Address - Zip Code:35541-4170
Mailing Address - Country:US
Mailing Address - Phone:256-606-0781
Mailing Address - Fax:
Practice Address - Street 1:105 FIRE STATION RD
Practice Address - Street 2:
Practice Address - City:BAILEYTON
Practice Address - State:AL
Practice Address - Zip Code:35019-9609
Practice Address - Country:US
Practice Address - Phone:256-735-4057
Practice Address - Fax:256-229-4816
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-118046363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health