Kimberly Randall Booker, CNM, WHNP-BC
Advanced Practice Midwife in Reidsville, NC. Individual provider (NPI-1).
NPI number1013359934
StatusActive
Last updated in NPPESAug 11, 2021
Details
- NPI
- 1013359934
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kimberly Randall Booker
- Credential
- CNM, WHNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 19, 2013
- Certification date
- Aug 11, 2021
- Last updated
- Aug 11, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CERTIFIED NURSE MIDWIFE (CNM)
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | 522 | NC | Yes |
| 363LW0102X | Nurse Practitioner, Women's Health | BOO104379455 | NC |
Practice location
520 Maple AveSuite C
Reidsville, NC 27320-4652
Phone 336-342-6063 · Fax 336-342-6066
Mailing address
3871 Vance Street ExtReidsville, NC 27320-8873
Phone 336-613-0904
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Other Advanced Practice Midwife providers in Reidsville, NC
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