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General NPI Number Information
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NPI Number | 1164888046
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Entity Type | Individual
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Provider Name | KIMBERLY D CREEL ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/08/2016
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 9900 BREN ROAD EAST MAIL ROUTE MN 008-B213
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City | MINNETONKA
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State | MN
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Zip | 55343
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Country | US
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Telephone | 229-220-2483
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 BREN ROAD EAST MAIL ROUTE MN 008-B213
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City | MINNETONKA
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State | MN
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Zip | 55343
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9315287
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License Number State | FL
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