Individual
KIMBERLY ANN WIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMH-NP
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Mailing address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1081
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R-172201-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902160746
—
MN
Enumeration date
06/29/2012
Last updated
04/26/2018
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