Individual
KIMBERLY BRENWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
218 3RD ST, ELKINS, WV 26241-3833
(304) 636-5195
Mailing address
218 3RD ST, ELKINS, WV 26241-3833
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
66746
WV
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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