Sally M Kidman, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

4704239762 Issued in MI

Practice address

535 S Burdick St Ste 256
Kalamazoo, MI 49007-6112

Phone

(269) 352-9977

NPI assigned

Apr 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1093334294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 FOUNTAIN SQUARE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490099531",
            "telephone_number": "269-352-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S BURDICK ST STE 256",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490076112",
            "telephone_number": "269-352-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDMAN",
        "first_name": "SALLY",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "MI",
            "license": "4704239762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salman Khan
• Wajid Khan, MD
• Zafir Zohab Hussain Khan, MD
• Latif Khillah, LPC
• Yousef Khozmi, M.D.
• Jena Kidney
• Rachael Kiefer
• Jean Maset Kieft, RN
• Whitney Kiel, PHARMD
• Lorenz P Kielhorn, M.D.

• Diabetes Educator Registered Nurse in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Diabetes Educator Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.