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Individual

DIANA KIMBAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP-BC

Contact information

Practice address
901 HARRY S TRUMAN DR N, LARGO, MD 20774-5477
(240) 677-1000
Mailing address
10714 NORMAN AVE, FAIRFAX, VA 22030-2931

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
0001236200
VA
363LN0000X
Neonatal Nurse Practitioner
Primary
AC005391
MD

Other

Enumeration date
10/20/2022
Last updated
07/21/2023
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