MEDICARE: KIMBERLY ALISON-MARIBBAY BADIOLA MSN, FNP-BC

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	363LP2300X	Primary Care Nurse Practitioner	831702	NV

General Provider Information

NPI Number	:	1952917833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ALISON-MARIBBAY BADIOLA MSN, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-877-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	2845 SIENA HEIGHTS DR STE 2100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4163
Country	:	US
Telephone Number	:	702-877-5199
Fax Number	:

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

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	03/26/2024

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