Individual
MS. KIMBERLY K. SOMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2575
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1449
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144244799
—
WI
Enumeration date
07/27/2006
Last updated
04/29/2022
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