Provider Demographics
NPI:1447493408
Name:WHITLEY, KIMBERLY R (PA)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:R
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:R
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:UK DIVISION OF DIGESTIVE DISEASES
Mailing Address - Street 2:800 ROSE ST., MN654 MED SCIENCE BLDG
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-4887
Mailing Address - Fax:859-257-8860
Practice Address - Street 1:UK DIVISION OF DIGESTIVE DISEASES
Practice Address - Street 2:800 ROSE ST., MN654 MED SCIENCE BLDG
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-0079
Practice Address - Fax:859-257-9287
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC007363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant