Individual
KIMBERLY SPIVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
10 4TH AVE SE, GLENWOOD, MN 56334-1820
(320) 634-4521
Mailing address
1240 W MAIN ST, PAYNESVILLE, MN 56362-1040
(701) 740-1890
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
12514
MN
363LP2300X
Primary Care Nurse Practitioner
12514
MN
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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