Basic Information
| Provider Information | |||||||||
| NPI: | 1154675866 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DONZE | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | SUE-HICKS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN/NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40 | ||||||||
| Address2: | |||||||||
| City: | SOUTHBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015500040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089097799 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 304 E SAUNDERS ST | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283279343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1094730009 | ||||||||
| FaxNumber: | 9109473035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2012 | ||||||||
| LastUpdateDate: | 06/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN261013 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 5011848 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.