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Individual
MRS. KIMBERLY MARIE KINKADE
Active
Individual
MRS. KIMBERLY MARIE KINKADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
25520
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175150023
MEDICARE
—
05
—
1760617005
—
IA
05
—
NP7962
—
SC
Enumeration date
05/15/2009
Last updated
02/09/2025
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