Individual
KASEY NICOLE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2340 W SYCAMORE ST, KOKOMO, IN 46901-4108
(654) 524-4377
Mailing address
2340 W SYCAMORE ST, KOKOMO, IN 46901-4108
(765) 452-4437
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28222341A
IN
363LF0000X
Family Nurse Practitioner
Primary
71010411A
IN
Other
Enumeration date
09/16/2020
Last updated
10/12/2020
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