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General NPI Number Information
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NPI Number | 1346800166
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Entity Type | Individual
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Provider Name | KIMBERLY ANN MAY REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 3111 ELECTRIC AVE
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City | PORT HURON
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State | MI
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Zip | 48060-8127
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Country | US
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Telephone | 810-985-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 1035 NEW JERSEY ST
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City | PORT HURON
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State | MI
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Zip | 48060-7805
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Country | US
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Telephone | 989-965-1470
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704254910
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License Number State | MI
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