KIMBERLY DONELSON (NPI# 1750537767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750537767 |
| Entity Type | Individual |
| Full Name | KIMBERLY DONELSON |
| Credential | CPNP |
| Practice Address |
1501 Kings Hwy Department of Pediatrics Shreveport LA 71103-4228 |
| Mailing Address |
1512 W Kirby Pl Shreveport LA 71103-3822 |
| Practice Telephone | 3186756093 |
| Practice Fax Number | 3186758832 |
| Mailing Telephone | 3186757636 |
| Mailing Fax Number | 3186757531 |
| Enumeration Date | 2008-08-09 |
| Last Update Date | 2011-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN089397 AP05554 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | MEDICARE - PTAN | 3A776F600 | 01 |
| LA | 1316865 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992124077 | Kimberly T Donelson | Speech-Language Pathologist | 6193 Guffin Cv, Bartlett, TN 38135-6151 | 2014-04-16 |
| Street Address |
1501 KINGS HWY DEPARTMENT OF PEDIATRICS |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1336747625 | Lana Nasief | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-09 |
| 1558968834 | Dinesh Regalla | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-08 |
| 1588261283 | Divleen Sidhu | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-06 |
| 1023624517 | Grace Hoffman | Pharmacist | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-20 |
| 1194330761 | Yousef Hasan | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1790399277 | Ricardo Murguia Fuentes | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1013521509 | Tahir Ahmad | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1376155309 | Ayesha Malik | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-20 |
| 1104438324 | Elleny Gutierrez | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103 | 2020-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376092510 | Tanquenika Markray | Nurse Practitioner | 351 Hearne Ave, Shreveport, LA 71103-2019 | 2016-09-29 |
| 1619226727 | Micah Boyett Pilcher | Nurse Practitioner | 9220 Ellerbe Rd Ste 700, Shreveport, LA 71106-6709 | 2012-09-05 |
| 1568489342 | Margaret S Raish | Nurse Practitioner | 410 W. 70th Street, Linwood School Based Health Center, Shreveport, LA 71106 | 2006-07-16 |
| 1568015584 | Lori J Phillips | Nurse Practitioner | 909 Olive St, Shreveport, LA 71104-2103 | 2019-07-18 |
| 1447810973 | Ashley C Viviano | Nurse Practitioner | 1919 Fairfield Ave, Shreveport, LA 71101-4436 | 2019-06-17 |
| 1104311778 | Amanda Carfagno | Nurse Practitioner | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2018-06-26 |
| 1528583549 | Jennipher Lyn Smothers | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2017-08-10 |
| 1598137374 | Jamiee Brice | Nurse Practitioner | 2520 Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71118-3130 | 2015-10-20 |
| 1336516533 | Holly Rivers | Nurse Practitioner | 2520 Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71118-3130 | 2015-08-24 |
| 1639545692 | Angela Moyer | Nurse Practitioner | 2520 Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71118-3130 | 2015-08-13 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on KIMBERLY DONELSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.