KIMBERLY EXTINE NP – NPI #1851525687
Nurse Practitioner

KIMBERLY EXTINE is a nurse practitioner located in MONROE, LA. NPPES has assigned the NPI number 1851525687 to KIMBERLY EXTINE on May 07, 2009. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 363LF0000X from the Health Care Provider Taxonomy code set, which is classified as Nurse Practitioner, specializing in Family

The NPI profile was previously updated about 7 years ago on Sep 19, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KIMBERLY EXTINE below.

NPI Profile for
KIMBERLY EXTINE

NPI Number
1851525687
Enumeration Date

(more than 17 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
KIMBERLY EXTINE
Credentials
NP
Primary location
2516 BROADMOOR BLVD STE 1D
MONROE, LA 71201
Phone: (318) 807-4746 Fax: (318) 812-6034
2 Other location(s):
2516 Broadmoor Blvd Ste 1D
Monroe, LA 71201
Phone: (318) 807-4746
Fax: (318) 812-6034
183 Hospital Rd
Suite #B
Winchester, TN 37398-2470
Phone: (931) 968-1232
Mailing address
130 DESIARD ST STE 355
MONROE, LA 71201-7363
Phone: (318) 807-7875 Fax: (318) 812-6603
Sole Proprietor
No
Updated
Identifiers

Identifiers for KIMBERLY EXTINE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDLA2486055
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
363LF0000X
- Nurse Practitioner / Family (Primary)
LA 201192
363L00000X
- Nurse Practitioner
LA 201192

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.