Individual
KIMBERLY PENNINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
975 WATERMAN AVE, EAST PROVIDENCE, RI 02914-1342
(401) 437-4884
Mailing address
25 KILEY ST, NORTH PROVIDENCE, RI 02911-2723
(401) 481-9329
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN50595
RI
163WH0200X
Home Health Registered Nurse
RN50595
RI
251E00000X
Home Health Agency
RN50595
RI
Other
Enumeration date
10/14/2014
Last updated
09/11/2023
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