Collin Kimball
Community Health Worker in Ketchikan, AK. Individual provider (NPI-1).
NPI number1548089873
StatusActive
Last updated in NPPESOct 3, 2024
Details
- NPI
- 1548089873
- Entity type
- Individual (NPI-1)
- Name
- Collin Kimball
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2024
- Certification date
- Oct 3, 2024
- Last updated
- Oct 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
30 Mountain Ash HtsKetchikan, AK 99901-9531
Phone 907-220-6092
Mailing address
30 Mountain Ash HtsKetchikan, AK 99901-9531
Phone 907-220-6092
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 48 Community Health Worker providers in Ketchikan · All 758 providers in Ketchikan
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