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General NPI Number Information
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NPI Number | 1861531501
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Entity Type | Individual
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Provider Name | JILL ANN KIMM MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 540 E JEFFERSON ST SUITE 301
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City | IOWA CITY
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State | IA
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Zip | 52245-2477
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Country | US
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Telephone | 319-688-7800
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Fax | 319-887-2879
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Provider Business Mailing Address
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Address Line | PO BOX 2027
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City | IOWA CITY
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State | IA
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Zip | 52244-2027
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Country | US
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Telephone | 319-339-3541
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Fax | 319-358-2737
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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 | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | C53654
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | C53654
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | C53654
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 23341
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 24640
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License Number State | IA
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