Individual provider · NPI-1

Kimberly L Ebersol, A.P.R.N.

Nurse Practitioner, Pediatrics · Columbia, MO

NPI number1679510390
StatusActive
Last updated in NPPESSep 14, 2022

Details

NPI
1679510390
Entity type
Individual (NPI-1)
Name
Kimberly L Ebersol
Credential
A.P.R.N.
Sex
Female
Sole proprietor
No
Enumeration date
Jun 1, 2006
Last updated
Sep 14, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics123260MOYes
363L00000X Nurse Practitioner123260MO
364SP0200X Clinical Nurse Specialist, Pediatrics123260MO

Practice location

404 N Keene St
Columbia, MO 65201-6626

Phone 573-882-3961 · Fax 573-884-4277

Mailing address

Po Box 843966
Kansas City, MO 64184-3966

Phone 573-884-3300 · Fax 573-884-0943

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