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

MS. Kimberly Diane Canupp, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1619552536

MS. Kimberly Diane Canupp, AGACNP is a Nurse Practitioner in Gainesville, Georgia. Qualified in 2022, 4 years ago. Practices with Northeast Georgia Physicians Group Inc, a 892-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2021
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Practice location Address checks out

743 Spring St NE
Gainesville, GA 30501-3715
Phone: (770) 219-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 83 E Point Dr, Dahlonega, GA 30533-6489 — (706) 969-9238

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence APRN-RN268584 (GA)

Record details

NPI number1619552536
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedMarch 11, 2021
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Northeast Georgia Physicians Group Inc — 892 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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