Provider Demographics
NPI:1174998421
Name:RESTREPO, KIMBERLY LYNNETTE
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LYNNETTE
Last Name:RESTREPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 E ABINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-4234
Mailing Address - Country:US
Mailing Address - Phone:864-764-4175
Mailing Address - Fax:
Practice Address - Street 1:562 E ABINGTON WAY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-4234
Practice Address - Country:US
Practice Address - Phone:864-764-4175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter