Individual
MS. REBECCA ELAINE KIMBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, CNP
Contact information
Practice address
801 KIDWELL DR, VERSAILLES, MO 65084-1787
(573) 378-5454
(573) 378-5055
Mailing address
801 KIDWELL DR, VERSAILLES, MO 65084-1787
(573) 378-5454
(573) 378-5055
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0063706
OK
363LF0000X
Family Nurse Practitioner
Primary
2013009202
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135570059
MEDICARE PTAN
MO
05
—
1427212976
—
MO
05
—
200205320A
—
OK
Enumeration date
07/14/2008
Last updated
10/04/2016
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