Individual
MS. KIMBERLY STATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTED NURSE
Contact information
Practice address
860 S RANCHO DR STE 10, LAS VEGAS, NV 89106-3828
(702) 268-8555
(702) 272-2541
Mailing address
860 S RANCHO DR STE 10, LAS VEGAS, NV 89106-3828
(702) 268-8555
(702) 272-2541
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
818769
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
818769
STATE OF NEVADA BOARD OF NURSING
NV
Enumeration date
09/22/2023
Last updated
09/29/2023
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