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NPI Code Detail

MEDICARE: KIMBERLY NESSETH R.N.

MEDICARE: KIMBERLY NESSETH R.N.
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
1163WP0808XPsychiatric/Mental Health Registered Nurse189837-30WI

General Provider Information

NPI Number : 1417396631
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY NESSETH R.N.
Provider Business Mailing Address
First Line : 11101 W LINCOLN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-1133
Country : US
Telephone Number : 414-203-4503
Fax Number : 414-328-3737
Provider Business Practice Location Address
First Line : 11101 W LINCOLN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-1133
Country : US
Telephone Number : 414-203-4503
Fax Number : 414-328-3737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2013
Last Update Date : 06/20/2013

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Directions to “ KIMBERLY NESSETH R.N.” Practice Location

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