Provider Demographics
NPI:1215426432
Name:HULL, KIMBERLY VILLEMARETTE (FNP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:VILLEMARETTE
Last Name:HULL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 WILD IRIS
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4681
Mailing Address - Country:US
Mailing Address - Phone:318-286-3786
Mailing Address - Fax:
Practice Address - Street 1:5025 SHED RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-5434
Practice Address - Country:US
Practice Address - Phone:318-795-4741
Practice Address - Fax:318-795-4742
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily