Individual
KIMBERLY SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5 INDUSTRIAL DR, MASHPEE, MA 02649-3464
(508) 778-4777
(508) 771-9555
Mailing address
297 NORTH ST STE 221, HYANNIS, MA 02601-5133
(508) 862-7777
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
160735
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP2292
BCBS
—
Enumeration date
12/29/2006
Last updated
06/20/2019
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