MEDICARE: KIMBERLY BRIGGS

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	163WS0200X	School Registered Nurse	661649	NY

General Provider Information

NPI Number	:	1942605472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BRIGGS

Provider Business Mailing Address
First Line	:	267 N COLLINGWOOD AVE
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13206-2203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 ROBINSON ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13206-3503
Country	:	US
Telephone Number	:	315-569-8703
Fax Number	:	315-435-4900

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

Provider Enumeration Date	:	10/27/2014
Last Update Date	:	10/27/2014

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Directions to “ KIMBERLY BRIGGS ” Practice Location

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