Provider Demographics
NPI:1447327184
Name:MISNER, KIMBERLY IRENE (DC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:IRENE
Last Name:MISNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WEST SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:732-775-5050
Mailing Address - Fax:732-774-7448
Practice Address - Street 1:185 WEST SYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE CITY
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-775-5050
Practice Address - Fax:732-774-7448
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00279000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ935761OtherAETNA
NJ043322OtherMEDICARE
NJP1622258OtherOXFORD
043322Medicare PIN