Individual
JILLIAN ALYSSA KIMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1147 PROFESSIONAL DR, GOSHEN, IN 46526-3800
(574) 364-2700
Mailing address
10296 WELBURN RD, THREE RIVERS, MI 49093-9217
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28247184A
IN
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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