Provider Demographics
NPI:1609575067
Name:KIMBLE, KIRA (CD)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:KIMBLE
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:PAW CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:28130-0343
Mailing Address - Country:US
Mailing Address - Phone:704-661-2278
Mailing Address - Fax:
Practice Address - Street 1:7032 CROSSRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-2216
Practice Address - Country:US
Practice Address - Phone:704-661-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula