MEDICARE: MRS. RIMPLE K MODY APN-C

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
1	363LP2300X	Primary Care Nurse Practitioner	26NJ00732200	NJ

General Provider Information

NPI Number	:	1639606197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RIMPLE K MODY APN-C

Provider Business Mailing Address
First Line	:	1 ANDERSON HILL RD STE 102
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2351
Country	:	US
Telephone Number	:	908-696-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 ANDERSON HILL RD STE 102
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2351
Country	:	US
Telephone Number	:	908-696-0808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2017
Last Update Date	:	05/15/2020

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