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NPI Code Detail

MEDICARE: SHEILA LYNNE KIMBLE-HAAS C.N.M., CFNP

MEDICARE: SHEILA LYNNE KIMBLE-HAAS C.N.M., CFNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse607019-1NY
2163WG0000XGeneral Practice Registered Nurse107645CO
3363LF0000XFamily Nurse PractitionerF335771-1NY
4367A00000XAdvanced Practice MidwifeF001331-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366470940
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEILA LYNNE KIMBLE-HAAS C.N.M., CFNP
Provider Business Mailing Address
First Line : 2960 TONGASS AVE
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5742
Country : US
Telephone Number : 907-228-4900
Fax Number : 800-852-3264
Provider Business Practice Location Address
First Line : 2960 TONGASS AVE
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5742
Country : US
Telephone Number : 907-228-4900
Fax Number : 800-852-3264
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 01/19/2017

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