Individual provider Active NPI

Nadia Marie Kimble, RN

  • Psychiatric/Mental Health Registered Nurse
  • Detroit, MI
National Provider Identifier
1396297115
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
4704410597 Issued in MI
Practice address
6309 Mack Ave
Detroit, MI 48207-2302
Phone
(313) 921-4700
NPI assigned
Oct 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703112661 MI
Registered Nurse 163W00000X 4704410597 MI
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704410597 MI Primary

Addresses

Primary practice location

6309 Mack Ave
Detroit, MI 48207-2302

Mailing address

6309 Mack Ave
Detroit, MI 48207-2302
Phone (313) 921-4700

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704410597MIMDRegistered Nurse
4703112661MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1396297115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-921-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-921-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "NADIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703112661",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704410597",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704410597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.