Provider Demographics
NPI:1306678438
Name:FARMER, KIMBERLY WARREN (ANP-C)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:WARREN
Last Name:FARMER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 COLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9913
Mailing Address - Country:US
Mailing Address - Phone:252-314-4141
Mailing Address - Fax:
Practice Address - Street 1:3121 MOSELEY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4245
Practice Address - Country:US
Practice Address - Phone:252-758-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC189939363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner