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NPI Code Detail

MEDICARE: JESSICA M KIMPS APNP

MEDICARE: JESSICA M KIMPS APNP
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
1363LF0000XFamily Nurse Practitioner6512-33WI

Other Identifiers

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

General Provider Information

NPI Number : 1831574169
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA M KIMPS APNP
Provider Business Mailing Address
First Line : 3 NEENAH CTR
Second Line :
City : NEENAH
State : WI
Zip : 54956-3070
Country : US
Telephone Number : 715-258-1041
Fax Number :
Provider Business Practice Location Address
First Line : 800 RIVERSIDE DR
Second Line :
City : WAUPACA
State : WI
Zip : 54981-1943
Country : US
Telephone Number : 715-258-1041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2015
Last Update Date : 03/06/2026

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