Individual
LISA KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
21247 SYRACUSE AVE, WARREN, MI 48091-4358
(586) 263-8772
(586) 263-8772
Mailing address
21247 SYRACUSE AVE, WARREN, MI 48091-4358
(586) 263-8772
(586) 263-8772
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704203442
MI
Other
Enumeration date
04/22/2009
Last updated
04/22/2009
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