Provider Demographics
NPI:1215073796
Name:CARANO, KIMBERLY ANN (PA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:CARANO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 BERING CT
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9573
Mailing Address - Country:US
Mailing Address - Phone:615-776-5124
Mailing Address - Fax:
Practice Address - Street 1:2933 MEDICAL CENTER PKWY STE A
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2391
Practice Address - Country:US
Practice Address - Phone:615-890-1455
Practice Address - Fax:615-890-1674
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0994363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPA0994OtherPA LICENSE NUMBER