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Individual

KIMMIE WEBB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4216 ORION AVE, LAS VEGAS, NV 89110-3222
(702) 498-9248
Mailing address
4216 ORION AVE, LAS VEGAS, NV 89110-3222
(702) 498-9248

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000088673
DRIVER'S LICENSE
NV
Enumeration date
04/25/2018
Last updated
04/25/2018
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