Provider Demographics
NPI:1841662095
Name:EDMUNDS-KIMREY, BARBARA LYNN (AGNP-BC)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LYNN
Last Name:EDMUNDS-KIMREY
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Gender:F
Credentials:AGNP-BC
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Mailing Address - Street 1:8801 HORIZON BLVD., SUITE 260
Mailing Address - Street 2:UNITED HEALTH CARE- OPTUM
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-798-6248
Mailing Address - Fax:855-758-0342
Practice Address - Street 1:8801 HORIZON BLVD., SUITE 260
Practice Address - Street 2:UNITED HEALTH CARE- OPTUM
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-798-6248
Practice Address - Fax:855-758-0342
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2016-05-11
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Provider Licenses
StateLicense IDTaxonomies
NMCNP-02788363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology