Provider Demographics
NPI:1679056527
Name:LITWILLER, KIMBERLY J (CRNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:LITWILLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:J
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1005 MAR WALT DR
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6707
Mailing Address - Country:US
Mailing Address - Phone:850-897-4400
Mailing Address - Fax:
Practice Address - Street 1:2001 E HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8826
Practice Address - Country:US
Practice Address - Phone:850-897-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022617363LF0000X
AL1-108342163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care