KIMBERLEY KOONTZ PMHNP NPI 1114560794

NPI Information

NPI: 1114560794
Provider Name: KIMBERLEY KOONTZ, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
3303 LATROBE DR
CHARLOTTE, NC
ZIP 28211
Phone: (704) 362-2663
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Kimberley Koontz, PMHNP is a psychiatric/mental health nurse practitioner in Charlotte, NC. Kimberley Koontz, PMHNP NPI is 1114560794. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3303 LATROBE DR
CHARLOTTE, NC
ZIP 28211-851
Phone: (704) 362-2663

The enumeration date for this NPI number is 10/25/2019 and was last updated on 10/29/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	5012464	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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