Provider Demographics
NPI:1215979240
Name:FRENCH, KIMBERLY Y (CRNA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:Y
Last Name:FRENCH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 ENTERPRISE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6300
Mailing Address - Country:US
Mailing Address - Phone:864-454-0888
Mailing Address - Fax:864-454-1130
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:2ND FLOOR ANESTHESIA DEPT.
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5611
Practice Address - Country:US
Practice Address - Phone:864-455-7111
Practice Address - Fax:864-455-6441
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN2480367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20038516OtherINDIVIDUAL SELECT HEALTH
SCP00279269OtherMEDICARE RAILROAD
SC20031911OtherSELECT HEALTH GROUP
SCQ33813Medicare ID - Type UnspecifiedMEDICARE ID
SC20038516OtherINDIVIDUAL SELECT HEALTH