MEDICARE: KIMBERLY RENEE HEMSLEY

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	313M00000X	Nursing Facility/Intermediate Care Facility

General Provider Information

NPI Number	:	1902660673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY RENEE HEMSLEY

Provider Business Mailing Address
First Line	:	8251 W SUNSET RD UNIT 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2295
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8251 W SUNSET RD UNIT 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2295
Country	:	US
Telephone Number	:	323-542-7846
Fax Number	:

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

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	02/12/2024

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Directions to “ KIMBERLY RENEE HEMSLEY ” Practice Location

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