Individual
KIMBERLY HERSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1075 JONES ST, KENNETT, MO 63857-3866
(573) 888-5925
Mailing address
1075 JONES STREET, KENNETT, MO 63857
(573) 888-5925
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
MO
Enumeration date
07/30/2015
Last updated
07/30/2015
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