Individual
KIMBERLY J HUMULOCK
Active
Individual
KIMBERLY J HUMULOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO00521
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-0336
UNITEDHEALTH CARE
RI
01
—
22405-7
BLUE CROSS & BLUE SHIELD
RI
01
—
407435
BLUE CHIP
RI
01
—
454709
TUFTS HEALTH PLAN
PR
01
—
7936235
AETNA HEALTH CARE
RI
05
—
9022405
—
RI
Enumeration date
04/18/2006
Last updated
01/31/2023
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