Organization
MOMS ARE US AND KIDS 2 PLLC
Active
Other names
Wild Rose Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN A KIMERLING (OPERATION MANAGER)
(509) 586-6248
Entity
Organization
Contact information
Practice address
207 N DENNIS ST, KENNEWICK, WA 99336-3129
(509) 460-4824
Mailing address
PO BOX 6762, KENNEWICK, WA 99336-0640
(509) 586-6248
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP30003677
WA
363LW0102X
Women's Health Nurse Practitioner
Primary
AP30002337
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7900970
—
WA
05
—
9635319
—
WA
Enumeration date
06/06/2008
Last updated
06/06/2008
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