Individual
KIMBERLEY KAY MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-BC
Contact information
Practice address
510 W ADAMS ST STE 150, PLYMOUTH, IN 46563-1789
(574) 335-7900
(574) 335-0850
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707
(574) 335-0741
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28175128A
IN
363LF0000X
Family Nurse Practitioner
Primary
71004269A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102333420
ANTHEM
IN
05
—
201128480
—
IN
Enumeration date
11/27/2012
Last updated
02/19/2024
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