Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kimberly Dawn Mitcham, FNP

Individual provider Family Nurse Practitioner · NPI 1720451297

Mrs. Kimberly Dawn Mitcham, FNP is a Nurse Practitioner in Baxley, Georgia. Qualified in 2012, 14 years ago. Practices with Diversity Health Center Inc, a 12-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2015
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

950 S Main St Ste 2
Baxley, GA 31513-0161
Phone: (912) 367-2596
Fax: (912) 367-8706
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN149433NP (GA)

Record details

NPI number1720451297
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedNovember 5, 2015
Last updated in NPPESJanuary 20, 2023
Certification dateJanuary 20, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Diversity Health Center Inc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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