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NPI Code Detail

MEDICARE: REBECCA MARIE KIMBROUGH

MEDICARE: REBECCA MARIE KIMBROUGH
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1972331726
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA MARIE KIMBROUGH
Provider Business Mailing Address
First Line : 319 A ST SW
Second Line :
City : MIAMI
State : OK
Zip : 74354-7605
Country : US
Telephone Number : 918-325-3400
Fax Number :
Provider Business Practice Location Address
First Line : 319 A ST SW
Second Line :
City : MIAMI
State : OK
Zip : 74354-7605
Country : US
Telephone Number : 918-325-3400
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 “ REBECCA MARIE KIMBROUGH ” Practice Location

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