Kimberly J Prough in Indian Harbour Beach - Physician Assistant
Kimberly J Prough - NPI 1902811698
Kimberly J Prough is a Physician Assistant in Indian Harbour Beach, Florida. Kimberly J Prough practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kimberly J Prough is 1902811698. The last update date is 2016-10-11.
Kimberly J Prough's current location address is 2254 Highway A1a, Indian Harbour Beach, Florida. You can contact this provider via phone number 3217772273 and fax number 3217797425. The mailing address for Kimberly J Prough is 2254 Highway A1a, Indian Harbour Beach, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberly J Prough |
|---|---|
| Address | 2254 Highway A1a, Indian Harbour Beach, Florida |
| Phone Number | 3217772273 |
| Fax Number | 3217797425 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1902811698 |
|---|---|
| Provider Enumeration Date | 2006-07-30 |
| Last Updated Date | 2016-10-11 |
Provider Mailing Address Detail
| Address | 2254 Highway A1a |
|---|---|
| City | Indian Harbour Beach |
| State | Florida (FL) |
| Post Code | 329374922 |
| Phone Number | 3217772273 |
| Fax Number | 3217797425 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA9104973 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8N8636 | TX | BLUECROSS BLUESHIELD | |
| 8Y0826 | TX | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Kimberly J Prough by the Centers for Medicare & Medicaid Services?
The Kimberly J Prough has been issued the NPI (National Provider Identifier) 1902811698, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Kimberly J Prough is physically located?
The Kimberly J Prough is situated at the following address: 2254 Highway A1A, Indian Harbour Beach, FL 329374922.
What is Kimberly J Prough's area of expertise and its corresponding taxonomy classification?
The Kimberly J Prough's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1902811698 to Kimberly J Prough?
The Centers for Medicare & Medicaid Services originally issued the 1902811698 to Kimberly J Prough on 2006-07-30.
When was the Kimberly J Prough's information last updated?
The Kimberly J Prough's information was last updated on 2016-10-11.
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