MEDICARE: MR. CHRISTOPHER KIMBI CNA, CMA

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
1	376K00000X	Nurse's Aide	263785	KS

General Provider Information

NPI Number	:	1730999723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER KIMBI CNA, CMA

Provider Business Mailing Address
First Line	:	1200 BROADWAY ST APT 8
Second Line	:
City	:	LARNED
State	:	KS
Zip	:	67550-2111
Country	:	US
Telephone Number	:	832-363-9021
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 CRESTVIEW LAKES EST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-2913
Country	:	US
Telephone Number	:	316-616-5306
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	01/10/2025

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