Provider Demographics
NPI:1982272837
Name:BRANHAM, KIM CAITLIN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:CAITLIN
Last Name:BRANHAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:CAITLIN
Other - Last Name:ALDERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7663 NORTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 NORTH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8806
Practice Address - Country:US
Practice Address - Phone:706-221-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN268140363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily