Provider Demographics
NPI:1265329288
Name:KIMBLE, MARINA NICOLE
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:NICOLE
Last Name:KIMBLE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13390 UPPER PATTERSON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26710-7369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13390 UPPER PATTERSON CREEK RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WV
Practice Address - Zip Code:26710-7369
Practice Address - Country:US
Practice Address - Phone:304-359-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide