Provider Demographics
NPI:1578868451
Name:DELAY, KIMBERLY N (CPM, LM)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:N
Last Name:DELAY
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33511 S LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-9292
Mailing Address - Country:US
Mailing Address - Phone:262-977-3070
Mailing Address - Fax:262-458-4105
Practice Address - Street 1:33511 S LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-9292
Practice Address - Country:US
Practice Address - Phone:262-977-3070
Practice Address - Fax:262-458-4105
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife