Organization
MOMS ARE US AND KIDS 2
Active
Other names
Wild Rose Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN A KIMERLING (OPERATIONS MANAGER)
(509) 551-9981
Entity
Organization
Contact information
Practice address
207 N DENNIS ST, KENNEWICK, WA 99336-3129
(509) 586-6248
(509) 586-7928
Mailing address
PO BOX 6762, KENNEWICK, WA 99336-0640
(509) 586-6248
(509) 586-7928
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30003677
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7900970
—
WA
05
—
9635319
—
WA
Enumeration date
06/10/2008
Last updated
06/10/2008
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