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NPI Code Detail

MEDICARE: MRS. KYMBERLEIGH NICOLE WILHELMY

MEDICARE: MRS. KYMBERLEIGH NICOLE WILHELMY
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
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10OTHERI DO NOT HAVE THIS INFORMATION

General Provider Information

NPI Number : 1811523525
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KYMBERLEIGH NICOLE WILHELMY
Provider Business Mailing Address
First Line : 2712 FREMONT AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1122
Country : US
Telephone Number : 612-872-8218
Fax Number : 612-874-8885
Provider Business Practice Location Address
First Line : 2712 FREMONT AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1122
Country : US
Telephone Number : 612-872-8218
Fax Number : 612-874-8885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2020
Last Update Date : 03/14/2020

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