Basic Information
| Provider Information | |||||||||
| NPI: | 1407412851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARGENT | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21975 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403214281 | ||||||||
| FaxNumber: | 5403214282 | ||||||||
| Practice Location | |||||||||
| Address1: | 541 SUNSET LN | ||||||||
| Address2: | |||||||||
| City: | CULPEPER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 227013979 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408294557 | ||||||||
| FaxNumber: | 5408254566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2019 | ||||||||
| LastUpdateDate: | 06/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 0001185246 | VA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.