Kimberly Duell, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704242599 Issued in MI

Practice address

801 Hazen St
Paw Paw, MI 49079-2008

Phone

(269) 657-5574

NPI assigned

Jul 24, 2019

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

Practice roles

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.

• Van Buren Community Mental Health Authority

  • Psychiatry Physician
  • Paw Paw, MI
  • NPI 1003878554
  NPD (past)

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1104479567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490790249",
            "telephone_number": "269-657-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HAZEN ST",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490792008",
            "telephone_number": "269-657-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUELL",
        "first_name": "KIMBERLY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704242599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domestic Violence Coalition, Inc.
• Kathleen Dorr
• Nicole Alayna Douglass, MA, LPC
• Dr. Jenny Grunberg DMD
• Kinju Dudhia, PT
• Pearce James Dupuis
• Kathleen L. Easterling, BSW
• Hugh Edwards
• Lori A Ellmer, LMSW
• McKenzie P Ellmer

• Registered Nurse in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.