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NPI Code Detail

MEDICARE: KIMBERLY OBOYLE

MEDICARE: KIMBERLY OBOYLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1275386641
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY OBOYLE
Provider Business Mailing Address
First Line : 104 E NORTH COUNTY LINE RD
Second Line :
City : SAINT LOUIS
State : MI
Zip : 48880-9709
Country : US
Telephone Number : 989-763-1518
Fax Number :
Provider Business Practice Location Address
First Line : 104 E NORTH COUNTY LINE RD
Second Line :
City : SAINT LOUIS
State : MI
Zip : 48880-9709
Country : US
Telephone Number : 989-763-1518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2024
Last Update Date : 04/08/2024

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Directions to “ KIMBERLY OBOYLE ” Practice Location

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