Organization
KIMBERLY JACKSON FNP LLC
Active
Other names
Kumuda Family Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A JACKSON FNP (OWNER/PROVIDER)
(914) 260-8087
Entity
Organization
Contact information
Practice address
31 WEBER HILL RD, MAHOPAC, NY 10541-1829
(914) 260-8087
(845) 767-5088
Mailing address
31 WEBER HILL RD, MAHOPAC, NY 10541-1829
(914) 260-8087
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
336506
NY
Other
Enumeration date
03/29/2016
Last updated
03/30/2016
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