Provider Demographics
NPI:1063785178
Name:DRURY, KIMBERLEY KAY (ARNP)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:KAY
Last Name:DRURY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E. DIXIE AVENUE
Mailing Address - Street 2:ATTN: EDNA P - CREDENTIALING
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748
Mailing Address - Country:US
Mailing Address - Phone:352-323-4267
Mailing Address - Fax:352-323-5039
Practice Address - Street 1:3543 LITTLE RD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1811
Practice Address - Country:US
Practice Address - Phone:727-848-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9237691363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily