Provider Demographics
NPI:1861603235
Name:RECTOR, KIM FERRELL (FNP)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:FERRELL
Last Name:RECTOR
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:915 TATE BLVD SUITE 170
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602
Mailing Address - Country:US
Mailing Address - Phone:828-234-1001
Mailing Address - Fax:828-345-0350
Practice Address - Street 1:915 TATE BLVD SE
Practice Address - Street 2:STE 170
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-345-0800
Practice Address - Fax:828-345-0350
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7005197Medicaid
NCNC2625AMedicare PIN