Individual
KIMBERLY ANNE CHARRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LMHP
Contact information
Practice address
2121 N WEBB RD, SUITE 200, GRAND ISLAND, NE 68803-1751
(308) 384-7119
Mailing address
PO BOX 5855, GRAND ISLAND, NE 68802-5855
(308) 384-7119
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1466
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025452000
—
NE
01
—
4765
MIDLANDS CHOICE PROVIDER
NE
01
—
84717
BCBS PROVIDER NUMBER
NE
Enumeration date
11/13/2006
Last updated
07/09/2007
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