Provider Demographics
NPI:1881070910
Name:WARLICK, KIMBERLY (ACNS-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:WARLICK
Suffix:
Gender:F
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MANTLE DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3972
Mailing Address - Country:US
Mailing Address - Phone:919-522-9430
Mailing Address - Fax:
Practice Address - Street 1:216 MANTLE DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-3972
Practice Address - Country:US
Practice Address - Phone:919-522-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79822163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator