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Organization
US ARMY
Active
Organization
US ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY ANN GENKOV DNP, PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(248) 909-7531
Entity
Organization
Contact information
Practice address
MADIGAN ARMY MEDICAL CTR, 9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-1110
Mailing address
800 ROE ST, STEILACOOM, WA 98388-4006
(248) 909-7531
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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