Kimberly M Disalle, RN
Individual provider Active NPI Medical-Surgical Registered Nurse · Phillipston, MA
NPI 1174388607 · NPPES record last updated Feb 14, 2024
Key facts
- NPI
- 1174388607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical-Surgical Registered Nurse 163WM0705X
- License
- RN2296847 (MA)
- Practice address
- 195 Blake Corner Rd # a
Phillipston, MA 01331-9793 - Phone
- (978) 895-0967
- NPI assigned
- Feb 14, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2296847 | MA | MD | Medical-Surgical Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | RN2296847 | MA | Yes |
Addresses
Primary practice location
195 Blake Corner Rd # a
Phillipston, MA 01331-9793
Mailing address
195 Blake Corner Rd # a
Phillipston, MA 01331-9793
Phone (978) 895-0967
Other providers in Phillipston, MA
- Fadi Baladi
- Monalisa Dupiton
- Fadi Baladi MD PC
- Alison Hietala
- Vanessa Lara Marshall
- My Stomping Ground LLC
- New Beginnings Center for Youth and Families
- Elizabeth Nottleson
- Daniella Nowicki
All providers in Phillipston, MA · Medical-Surgical Registered Nurse in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.