Provider Demographics
NPI:1982910758
Name:GOLDINGER, KIM E (NP)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:E
Last Name:GOLDINGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-2611
Mailing Address - Country:US
Mailing Address - Phone:931-424-7389
Mailing Address - Fax:931-363-9891
Practice Address - Street 1:625 W MADISON ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-2611
Practice Address - Country:US
Practice Address - Phone:931-424-7389
Practice Address - Fax:931-363-9891
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily