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Individual
JUSTIN KIMMEL
Active
Individual
JUSTIN KIMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1969603
MN
163WG0000X
General Practice Registered Nurse
75163
NM
363LP2300X
Primary Care Nurse Practitioner
Primary
10652
MN
363LP2300X
Primary Care Nurse Practitioner
75163
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
10/27/2020
Last updated
03/04/2026
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