Kimberly R York, RN

Individual provider Active NPI Community Health Registered Nurse · San Fidel, NM

NPI 1699967331 · NPPES record last updated Oct 27, 2007

Key facts

NPI
1699967331
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
492058 (NY)
Practice address
1-40 Exit 102
San Fidel, NM 87049-0130
Phone
(505) 552-5438
Fax
(505) 552-5811
NPI assigned
Aug 16, 2007
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

LicenseStateTypeSpecialty
492058NYMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 492058 NY
Community Health Registered Nurse 163WC1500X 492058 NY Yes

Addresses

Primary practice location

1-40 Exit 102
San Fidel, NM 87049-0130

Mailing address

PO Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5438

Other identifiers

IdentifierTypeStateIssuer
492058OtherNYNURSING

Other names

  • Kimberly R Phillips Other name

Other providers in San Fidel, NM

All providers in San Fidel, NM · Community Health Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.