Provider Demographics
NPI:1982469706
Name:DUNCAN, KIYOMI LEE MIYAMOTO (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KIYOMI
Middle Name:LEE MIYAMOTO
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9130 CURTIS RD
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37871-1502
Mailing Address - Country:US
Mailing Address - Phone:865-360-6654
Mailing Address - Fax:
Practice Address - Street 1:9130 CURTIS RD
Practice Address - Street 2:
Practice Address - City:STRAWBERRY PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37871-1502
Practice Address - Country:US
Practice Address - Phone:865-360-6654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3875165171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach