MRS. KIMBERLY DENISE FEDRICK


Address: 300 W Hospital Rd, Augusta, GA 30905-5741
Phone: 7067877471

MRS. KIMBERLY DENISE FEDRICK (NPI# 1801059589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801059589
Entity Type Individual
Full Name MRS. KIMBERLY DENISE FEDRICK
Credential LPN
Practice Address 300 W Hospital Rd
Augusta
GA 30905-5741
Mailing Address 2503 Inverness Dr
Hephzibah
GA 30815-5845
Practice Telephone 7067877471
Mailing Telephone 7067984658
Enumeration Date 2008-07-03
Last Update Date 2008-07-03
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 164W00000X Licensed Practical Nurse 062344 GA Nursing Service Providers

Office Location

Street Address 300 W HOSPITAL RD
City AUGUSTA
State GA
Zip Code 30905-5741

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689832453 Briggitte Pierce Licensed Practical Nurse 300 W Hospital Rd, Augusta, GA 30905-5741 2008-05-29
1316113426 Arthur James Caruthers Technician, Other 300 W Hospital Rd, Eisenhower Army Medical Center, Augusta, GA 30905-5741 2008-05-08
1649443888 Melissa Marie Baklarz Registered Nurse 300 W Hospital Rd, Augusta, GA 30905-5741 2008-04-09
1285817189 James Robert Nolin Nurse Practitioner 300 W Hospital Rd, Augusta, GA 30905-5741 2007-12-13
1710030044 Nathan Andrew Marsh Orthopaedic Surgery 300 W Hospital Rd, Eisenhower Army Medical Center, Attn Credentials, Augusta, GA 30905-5741 2007-01-19
1689727091 Brock Alan Benedict Family Medicine 300 W Hospital Rd, Augusta, GA 30905-5741 2007-01-19
1598827438 Jacqueline F Hillesland Social Worker 300 W Hospital Rd, Eisenhower Army Medical Center, Augusta, GA 30905-5741 2006-12-15
1831251636 Sandra Jean Shelmerdine Psychiatry & Neurology 300 W Hospital Rd, Eisenhower Army Medical Center Attn Credential, Augusta, GA 30905-5741 2006-12-15
1396807681 Brenda L. Galeas Nurse Anesthetist, Certified Registered 300 W Hospital Rd, Eisenhower Amc, Augusta, GA 30905-5741 2006-12-14
1710049093 Terry Lawrence Andrews Family Medicine 300 W Hospital Rd, Eamc Attn Credentials, Augusta, GA 30905-5741 2006-12-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417508995 Priscilla Denise Brown Prosthetic/Orthotic Supplier 38200 3rd Ave, Fort Gordon, GA 30905 2019-09-25
1740754308 Patricia Lynn Blevins Nurse Practitioner 300 E Hospital Dr, Augusta, GA 30905 2019-01-17
1861971335 Isabella Anderson Dentist Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 2018-08-07
1972097426 Cortney Wolfley Student in an Organized Health Care Education/Training Program Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 2018-06-19
1003337536 David Jonathon Sabovich Dentist 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 2017-07-06
1437689411 Marcos Aranda Student in an Organized Health Care Education/Training Program General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 2017-06-13
1659809846 Brian Kevin Burke Student in an Organized Health Care Education/Training Program 300 East Hosptial Road, Fort Gordon, GA 30905 2017-06-01
1902334469 Jacqueline Renee Mulhall Student in an Organized Health Care Education/Training Program Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 2017-05-30
1750837456 Amanda R Bailey Internal Medicine 300 E. Hospital Dr., Fort Gordon, GA 30905 2016-09-01
1689120016 Thomas S Moffitt Internal Medicine Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 2016-08-26
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Taxonomy Information

Taxonomy Code 164W00000X
Grouping Nursing Service Providers
Classification Licensed Practical Nurse

Taxonomy Definition

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730709866 Michelle Gonzalez Licensed Practical Nurse 7906 N 39th St, Augusta, MI 49012-9714 2020-04-18
1104215565 Valerie Louise Potter Licensed Practical Nurse 4928 Ford Hill Road, Augusta, WV 26704 2015-01-22
1407129448 Kimberly R Garcia Licensed Practical Nurse 3902 Creekwood Ln, Augusta, GA 30907-2422 2012-02-22
1144593906 Terence Alan Dunavan Licensed Practical Nurse 1506 Pendleton Rd, Augusta, GA 30904-4840 2012-02-09
1861790891 Tina Maria Mays Licensed Practical Nurse Hc 71 Box 115m, Augusta, WV 26704 2011-02-28
1922235076 Day Break Medical Resource Group Licensed Practical Nurse 4349 White Pine Ct, Augusta, GA 30906-8122 2009-06-16
1841448024 Kenya Cook Jones Licensed Practical Nurse 1 Freedom Way # 5, Augusta, GA 30904-6258 2008-08-31
1760654826 Shirlene Demetra Williams Licensed Practical Nurse 2545 Sandra Dr, Augusta, GA 30906-2843 2008-03-29
1861697187 Kendra Celeste Cunningham Licensed Practical Nurse 1243 Pine St, Augusta, GA 30901-3334 2007-06-18
1053498550 Arnita F. Thomas Licensed Practical Nurse 2420 Windsor Spring Rd, Augusta, GA 30906-4668 2006-11-01
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City AUGUSTA
Zip Code 30905

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Dataset Information

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.

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