Individual
DR. KYMBERLY J LIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3100
(641) 672-3111
Mailing address
1229 C AVE E, OSKALOOSA, IA 52577-4246
(641) 672-3100
(641) 672-3111
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
02450
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05520
IA BLUE SHIELD PROVIDER N
IA
05
—
3069252
—
IA
01
—
P0021924
RR MEDICARE PROVIDER NUMB
IA
Enumeration date
01/16/2006
Last updated
07/09/2009
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