KIMBERLY RENEE WYNN (NPI# 1962991893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962991893 |
| Entity Type | Individual |
| Full Name | KIMBERLY RENEE WYNN |
| Other Name | KIMBERLY RENEE BLANKENSHIP |
| Credential | LPN |
| Practice Address |
4330 Maynardville Hwy Maynardville TN 37807-3618 |
| Mailing Address |
1923 Sulphur Springs Rd Morristown TN 37813-5654 |
| Practice Telephone | 8659923849 |
| Practice Fax Number | 8659925166 |
| Mailing Telephone | 4233179344 |
| Mailing Fax Number | 4237142355 |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | LPN83568 | TN | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891328860 | Kimberly Wynn | Social Worker | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2020-02-19 |
| 1689069510 | Kimberly Wynn | Speech-Language Pathologist | 700 19th St S, Birmingham, AL 35233-1927 | 2015-03-30 |
| 1336149673 | Kimberly Carol Wynn | Physician Assistant | 610 E Martin Luther King Jr Dr, Maxton, NC 28364-1800 | 2005-07-28 |
| Street Address |
4330 MAYNARDVILLE HWY |
| City | MAYNARDVILLE |
| State | TN |
| Zip Code | 37807-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801894001 | Jeffrey D Greenwood | Psychiatry & Neurology | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2005-07-12 |
| 1518512367 | Melanie Dupree Norman | Developmental Therapist | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2019-08-08 |
| 1699335190 | Chelsey Germaine Keyes | Dental Assistant | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2019-06-17 |
| 1881166809 | Margaret Stallard | Licensed Practical Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2019-01-02 |
| 1780155960 | Glenda Gill | Dental Assistant | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-12-16 |
| 1528539038 | Tanya Hodges | Dental Hygienist | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-12-10 |
| 1649741380 | Brenda Stanley | Nurse's Aide | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-12-06 |
| 1427528355 | April Dawn Cooke | Registered Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-12-04 |
| 1548730815 | Amanda Gail Farmer | Nurse's Aide | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-11-29 |
| 1396228136 | Misty Danielle Sexton | Licensed Practical Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368815 | Ian Carter Mccormick | Pharmacist | 2710 Maynardville Highway, Maynardville, TN 37807 | 2020-08-25 |
| 1053963975 | Maynardville Drug LLC | Pharmacy | 2975 Maynardville Hwy, Maynardville, TN 37807 | 2019-07-11 |
| 1811014533 | Leah Renee Lewis | Specialist/Technologist | 108 Harmon Drive, Maynardville, TN 37807 | 2007-03-26 |
| 1659497394 | Mohammad Bhidya Md PC | Nurse Practitioner | 2595 Maynardville Hwy, Maynardville, TN 37807 | 2007-03-22 |
| 1053350363 | Thomas J Demaro | Emergency Medicine | 598 John Deere Drive, Maynardville, TN 37807 | 2006-06-05 |
| 1134504764 | East Tennessee Physical Therapy,llc | Clinic/Center | 4357 Maynardville Hwy, Maynardville, TN 37807 | 2015-07-24 |
| 1447500731 | Julie M Roberts | Pharmacist | 4344 Maynardville Hwy, Maynardville, TN 37807 | 2012-09-13 |
| 1669623898 | Stallion Medical Group P.C. | Family Medicine | 598 John Deere Drive, Maynardville, TN 37807 | 2008-10-07 |
| 1952442618 | Lisa D Smallen-lee | Nutritionist | 4335 Maynardville Hwy, Maynardville, TN 37807 | 2007-02-08 |
| 1033279872 | Darrell James Johnson | Chiropractor | 110 Skyline Drive, Maynardville, TN 37807 | 2006-12-11 |
| Find all providers in zip 37807 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881166809 | Margaret Stallard | Licensed Practical Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2019-01-02 |
| 1396228136 | Misty Danielle Sexton | Licensed Practical Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-09-07 |
| 1336647486 | Rhonda Kay Bates | Licensed Practical Nurse | 4330 Maynardville Hwy, Maynardville, TN 37807-3618 | 2018-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001784 | Natalie Raye Higginbotham | Licensed Practical Nurse | 505 E Ash St, La Follette, TN 37766-2529 | 2020-10-22 |
| 1750989521 | April Nicole Milam | Licensed Practical Nurse | 600 Jefferson Ave Ste 350, Memphis, TN 38105-4900 | 2020-10-14 |
| 1922606953 | Latonya Rochelle Addison | Licensed Practical Nurse | 8855 N Cortona Cir, Cordova, TN 38018-6978 | 2020-10-12 |
| 1487269437 | Cathy Jones | Licensed Practical Nurse | 2047 Dutch Valley Rd, Clinton, TN 37716-5121 | 2020-09-15 |
| 1902410855 | Jessica Adams | Licensed Practical Nurse | 1496 Dardon Ave, Memphis, TN 38116-8410 | 2020-09-08 |
| 1639782733 | Maresa Grines Huggins | Licensed Practical Nurse | 6939 7th Rd, Bartlett, TN 38135-2582 | 2020-08-28 |
| 1326659483 | Kristen Julia Rash | Licensed Practical Nurse | 1813 6th Ave, Knoxville, TN 37917-5830 | 2020-08-12 |
| 1215545942 | Rhonda Jean Jeffers | Licensed Practical Nurse | 3860 Helenwood Loop Rd, Helenwood, TN 37755-5562 | 2020-07-20 |
| 1881210953 | Jennifer Higginbotham | Licensed Practical Nurse | 1126 Cross Valley Rd, La Follette, TN 37766-4964 | 2020-06-24 |
| 1043833775 | Selena Myers | Licensed Practical Nurse | 2125 Old County Garage Rd, Helenwood, TN 37755-5385 | 2020-05-28 |
| Find all providers with the same taxonomy | ||||
| City | MAYNARDVILLE |
| Zip Code | 37807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.