Individual
MR. DAVID FISHER KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN CNS
Contact information
Practice address
20 RESEARCH PKWY, OLD SAYBROOK, CT 06475-4214
(800) 370-3651
(860) 510-0020
Mailing address
20 STANLEY AVE, MEDFORD, MA 02155-5618
(781) 874-0592
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
239643
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004745
NHP
—
01
—
1303287
MBHP
—
05
—
1303287
—
MA
01
—
703136
TUFTS
—
01
—
99618201
NETWORK HEALTH
—
01
—
CP0110
BCBS
MA
01
—
M18633
BCBS
MA
01
—
NP10332
BOSTON MED CTR
—
01
—
NS045901
MEDICARE ID
MA
Enumeration date
11/21/2006
Last updated
11/26/2007
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