Individual provider Active NPI

Kimberly K Huntley, LPN

  • Licensed Practical Nurse
  • Vancouver, WA
National Provider Identifier
1043983042
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP60803576 Issued in WA
Practice address
15708 NE 48TH St
Vancouver, WA 98682-5206
Phone
(360) 600-9090
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP60803576 WA Primary

Addresses

Primary practice location

15708 NE 48TH St
Vancouver, WA 98682-5206

Mailing address

15708 NE 48TH St
Vancouver, WA 98682-5206
Phone (360) 600-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP60803576WAMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1043983042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15708 NE 48TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986825206",
            "telephone_number": "360-600-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15708 NE 48TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986825206",
            "telephone_number": "360-600-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTLEY",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60803576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.