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Individual

KIMBERLY S. NISSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
2815 CAMINO DEL RIO S, SUITE 115, SAN DIEGO, CA 92108-3815
(619) 886-5057
(760) 458-4428
Mailing address
PO BOX 881304, SAN DIEGO, CA 92168-1304
(619) 886-5057
(760) 458-4428

Taxonomy

Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
RN532252
CA

Other

Enumeration date
09/13/2012
Last updated
10/25/2012
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