Jenny Beth Kimberly, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Carthage, IN

NPI 1083620264 · NPPES record last updated Oct 28, 2012

Key facts

NPI
1083620264
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
309-002631 (IL)
Practice address
8401 N Rushville Rd
Carthage, IN 46115-9771
Phone
(847) 612-2199
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
309-002631ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Orion Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past
since Nov 1, 2002
Accepting new patients
Westview Anesthesia Group, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 309-002631 IL Yes

Addresses

Primary practice location

8401 N Rushville Rd
Carthage, IN 46115-9771

Mailing address

8401 N Rushville Rd
Carthage, IN 46115-9771
Phone (847) 612-2199

Other providers in Carthage, IN

All providers in Carthage, IN · Certified Registered Nurse Anesthetist in Indiana

Sources for this page

Verify at the official NPI Registry.