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NPI Code Detail

MEDICARE: EBONY LADONNA TRULER KIMMINS REGISTERED NURSE

MEDICARE: EBONY LADONNA TRULER KIMMINS REGISTERED NURSE
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 Nurse14-161850-031KS

General Provider Information

NPI Number : 1841028768
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONY LADONNA TRULER KIMMINS REGISTERED NURSE
Provider Business Mailing Address
First Line : 4404 BOOTH ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-3419
Country : US
Telephone Number : 573-823-3540
Fax Number :
Provider Business Practice Location Address
First Line : 4404 BOOTH ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-3419
Country : US
Telephone Number : 913-381-8233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2024
Last Update Date : 07/23/2024

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Directions to “ EBONY LADONNA TRULER KIMMINS REGISTERED NURSE” Practice Location

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