Individual
MS. CARRIE LELANIA KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
31 PLUM AVE, TROY, NY 12180-5815
(267) 456-2129
Mailing address
31 PLUM AVE, TROY, NY 12180-5815
(267) 456-2129
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F404998-01
NY
Other
Enumeration date
06/05/2013
Last updated
08/20/2023
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