Provider Demographics
NPI:1548728132
Name:SUMNER-BROOKS, KIMBERLY RANEE (APRN)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RANEE
Last Name:SUMNER-BROOKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6329 CRESCENT LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7922
Mailing Address - Country:US
Mailing Address - Phone:561-385-0714
Mailing Address - Fax:561-799-5427
Practice Address - Street 1:3370 BURNS RD STE 102
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4327
Practice Address - Country:US
Practice Address - Phone:561-799-5417
Practice Address - Fax:561-799-5427
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3073512363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care