# KIM GENET MOFFATT-BAZILE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1619003928
- **Gender:** F
- **Credential:** PNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0200X | Pediatric Registered Nurse | APRN001811 | NV | — |
| 163WP0200X | Pediatric Registered Nurse | RN80724 | NV | — |
| 363L00000X | Nurse Practitioner | 8485 | CA | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 05/16/2019