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General NPI Number Information
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NPI Number | 1962898288
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Entity Type | Individual
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Provider Name | KIMBERLY LADINE RN
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/02/2017
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Provider Practice Location Address
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Address Line | 1700 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-2803
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Country | US
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Telephone | 209-526-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 BALL CT
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City | TURLOCK
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State | CA
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Zip | 95382-1009
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Country | US
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Telephone | 209-202-6744
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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 | 95052167
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License Number State | CA
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