Olivia Kimble, LTM, CPM, MSM
Individual provider Active NPI Midwife · Pine Island, MN
NPI 1194171801 · NPPES record last updated Jan 27, 2021
Key facts
- NPI
- 1194171801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 1083 (MN)
- Practice address
- 1001 Trail View LN SE
Pine Island, MN 55963-8608 - Phone
- (720) 982-9530
- NPI assigned
- May 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1083 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Birth Group | Past | Accepting new patients | |
| National Birth Centers, Inc. | Past | Accepting new patients | |
| Private Healthcare Facilities | Past | Accepting new patients | |
| Edge Medical Services | Past | Accepting new patients | |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | |||
| Midwife | 176B00000X | 1083 | MN | Yes |
Addresses
Primary practice location
1001 Trail View LN SE
Pine Island, MN 55963-8608
Mailing address
1001 Trail View LN SE
Pine Island, MN 55963-8608
Phone (720) 982-9530
Other providers in Pine Island, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2021. 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.