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Individual
KIMBERLY FAITH FEDKIW
Active
Individual
KIMBERLY FAITH FEDKIW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, ANP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F333039-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027261403
UNIVERA
NY
01
—
00060970004
BLUE CROSS/BLUE SHIEL
NY
05
—
02672984
—
NY
01
—
F333039-1
LICENSE
NY
Enumeration date
07/02/2006
Last updated
09/23/2020
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