Provider Demographics
NPI:1316430382
Name:BISS, KIMBERLY MARIE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MARIE
Last Name:BISS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1327
Mailing Address - Country:US
Mailing Address - Phone:336-392-4243
Mailing Address - Fax:
Practice Address - Street 1:101 HOSPICE LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5766
Practice Address - Country:US
Practice Address - Phone:336-768-3972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010595363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily