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Individual

STACY LOUISE KIMBROUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5135 CAMINO AL NORTE STE 150, NORTH LAS VEGAS, NV 89031-2388
(702) 853-6714
Mailing address
5135 CAMINO AL NORTE STE 150, NORTH LAS VEGAS, NV 89031-2388
(702) 853-6714

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
376J00000X
Homemaker

Other

Enumeration date
07/30/2019
Last updated
07/30/2019
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