Provider Demographics
NPI:1063950723
Name:BUFF, KIMBERLY KAY (ARNP, FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:BUFF
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 RUCKER RD
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-5281
Mailing Address - Country:US
Mailing Address - Phone:540-297-7181
Mailing Address - Fax:434-200-1700
Practice Address - Street 1:200 AVENUE F NE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4131
Practice Address - Country:US
Practice Address - Phone:863-293-1121
Practice Address - Fax:863-291-6028
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177664363LF0000X
FLAPRN9307765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily