Provider Demographics
NPI:1023482023
Name:HANDY, KIMBERLY RAE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RAE
Last Name:HANDY
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:RAE
Other - Last Name:STALNAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:11 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27281-9730
Mailing Address - Country:US
Mailing Address - Phone:760-978-9706
Mailing Address - Fax:910-967-6084
Practice Address - Street 1:1135 KILDAIRE FARM RD STE 108
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4587
Practice Address - Country:US
Practice Address - Phone:919-694-7192
Practice Address - Fax:919-313-6215
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-15
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003905363LP2300X, 363LF0000X
NC5016551363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily