Individual
KEVIN KIMMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
601 COLLIERS WAY, WEIRTON, WV 26062-5014
(304) 797-6000
Mailing address
601 COLLIERS WAY, WEIRTON, WV 26062-5014
(304) 797-6000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
59986
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38010004792
—
WV
01
—
550387249
TAX ID
—
Enumeration date
02/18/2007
Last updated
07/09/2007
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