Individual provider · NPI-1

Jacquelyn Kimball, RN

Registered Nurse, General Practice · Wilmington, DE

NPI number1265080857
StatusActive
Last updated in NPPESAug 28, 2019

Details

NPI
1265080857
Entity type
Individual (NPI-1)
Name
Jacquelyn Kimball
Credential
RN
Sex
Female
Sole proprietor
No
Enumeration date
Aug 28, 2019
Last updated
Aug 28, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General PracticeL1-0045379DEYes

Practice location

1311 Brandywine Blvd
Wilmington, DE 19809-2306

Phone 302-529-3118

Mailing address

1311 Brandywine Blvd
Wilmington, DE 19809-2306

Phone 302-529-3118

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