Kimberly A Delaigle, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN198576 Issued in GA

Practice address

3475 Riverwatch Parkway, Suite 310
Martinez, GA 30907

Phone

(706) 447-2461

Fax

(706) 447-2465

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1124594718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 SUSSEX DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098232",
            "telephone_number": "706-836-2883",
            "fax_number": "706-504-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 RIVERWATCH PARKWAY, SUITE 310",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "30907",
            "telephone_number": "706-447-2461",
            "fax_number": "706-447-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAIGLE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN198576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Alemar DMD PC
• David Petsch Enterprises, Inc.
• Brianna Davis
• J Perry Davis, DMD
• Delton Wade De Vose, PHD, LPCS, CCS, BCTM
• Lori Delaigle
• Dara A Delancy, PSYD
• A'Niyah Delee
• Mary C Dement, MD
• Daelynn Dempsey

• Family Nurse Practitioner in Martinez, GA
• Providers in Martinez, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.