Provider Demographics
NPI:1912963620
Name:HAND, KIMBERLY D (PA-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:HAND
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3831 PIPER ST
Mailing Address - Street 2:STE S220
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4680
Mailing Address - Country:US
Mailing Address - Phone:317-888-1051
Mailing Address - Fax:317-888-1591
Practice Address - Street 1:8141 SOUTH EMERSON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237
Practice Address - Country:US
Practice Address - Phone:317-888-1051
Practice Address - Fax:317-888-1591
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2016-01-25
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Provider Licenses
StateLicense IDTaxonomies
IN10000847A363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN219850KMedicare PIN
INQ67048Medicare UPIN