Healthcare Provider Details

I. General information

NPI: 1487577912
Provider Name (Legal Business Name): KIMBERLY ROBYN ORMISTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 WOODLAND DR APT 623
NEW ORLEANS LA
70131-7617
US

IV. Provider business mailing address

5000 WOODLAND DR APT 623
NEW ORLEANS LA
70131-7617
US

V. Phone/Fax

Practice location:
  • Phone: 504-220-6338
  • Fax:
Mailing address:
  • Phone: 504-220-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA7609
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: