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NPI Code Detail

MEDICARE: KIMBERLY ANNE SUTHERLAND

MEDICARE: KIMBERLY ANNE SUTHERLAND
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1558610204
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANNE SUTHERLAND
Provider Business Mailing Address
First Line : 3095 E PATRICK LN
Second Line : SUITE #12
City : LAS VEGAS
State : NV
Zip : 89120-4932
Country : US
Telephone Number : 702-483-5919
Fax Number :
Provider Business Practice Location Address
First Line : 3095 E PATRICK LN
Second Line : SUITE #12
City : LAS VEGAS
State : NV
Zip : 89120-4932
Country : US
Telephone Number : 702-483-5919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2012
Last Update Date : 11/10/2014

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Directions to “ KIMBERLY ANNE SUTHERLAND ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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