Provider Demographics
NPI:1881124071
Name:PRITCHETT, KIMBERLY VAN NESS (FNP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:VAN NESS
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:MEGAN
Other - Last Name:VAN NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:840 PINE ST STE 780
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201
Mailing Address - Country:US
Mailing Address - Phone:478-744-2445
Mailing Address - Fax:478-744-0906
Practice Address - Street 1:CENTRAL GEORGIA PULMONARY
Practice Address - Street 2:840 PINE ST STE 780
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201
Practice Address - Country:US
Practice Address - Phone:478-744-2445
Practice Address - Fax:478-744-0906
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN223448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily