Individual
KIMBERLY STUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4 GREENTREE DR, WATERFORD, CT 06385-4116
(860) 442-0647
Mailing address
1643 NW 136TH AVE, SUNRISE, FL 33323-3091
(954) 377-2939
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14031
CT
363LG0600X
Gerontology Nurse Practitioner
Primary
14031
CT
Other
Enumeration date
10/22/2024
Last updated
05/06/2025
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