Individual
KIMBERLY TITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
706 DEBBIE LN, CARVER, MN 55315-9306
(612) 207-0397
Mailing address
721 HARVEST CT, SHAKOPEE, MN 55379-8263
(612) 207-0397
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
193593-8
MN
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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