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NPI Code Detail

MEDICARE: KIMBERLY KILKENNY

MEDICARE: KIMBERLY KILKENNY
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
1101YM0800XMental Health Counselor947AK

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 : 1861714842
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY KILKENNY
Provider Business Mailing Address
First Line : 2600 CORDOVA ST STE 101
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2745
Country : US
Telephone Number : 907-600-3425
Fax Number :
Provider Business Practice Location Address
First Line : 8012 STEWART MOUNTAIN DR
Second Line :
City : EAGLE RIVER
State : AK
Zip : 99577-9013
Country : US
Telephone Number : 907-772-3332
Fax Number : 888-858-8850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2010
Last Update Date : 05/06/2026

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Directions to “ KIMBERLY KILKENNY ” 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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