Individual
KIMBLE BREAZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
702 N PERSON ST, RALEIGH, NC 27604-1216
(919) 626-4917
Mailing address
4133 BAY RUM LN, RALEIGH, NC 27610-6333
(719) 439-1571
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HC5252
NC
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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