Individual
JACQUELYNNE M KIMANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
40 JACKSON ST STE 1050, WORCESTER, MA 01608-2313
(774) 420-8961
Mailing address
40 JACKSON ST STE 1050, WORCESTER, MA 01608-2313
(774) 420-8961
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2283682
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2283682
MA
Other
Enumeration date
01/02/2021
Last updated
12/19/2021
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