Provider Demographics
NPI:1548375041
Name:MOYERS, KIMBERLY N (RN, MSN, NP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:N
Last Name:MOYERS
Suffix:
Gender:F
Credentials:RN, MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 JACKSON RIVER TPKE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24445-2548
Mailing Address - Country:US
Mailing Address - Phone:540-522-8802
Mailing Address - Fax:
Practice Address - Street 1:1 ARH LANE
Practice Address - Street 2:SUITE 800
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-862-6750
Practice Address - Fax:540-862-3742
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN49612NP363LF0000X
VA0024165861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010118352Medicaid
VAVV4007AOtherMEDICARE PTAN
VAVV4007AOtherMEDICARE PTAN
VAQ41356Medicare UPIN
VA010118352Medicaid
WVWV5393C551Medicare PIN
WVWV5393AMedicare PIN