Provider Demographics
NPI:1003521071
Name:KIMMEL, ROBIN ADEIRE (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:ADEIRE
Last Name:KIMMEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32196 SW JOHNSON SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:OR
Mailing Address - Zip Code:97113-6224
Mailing Address - Country:US
Mailing Address - Phone:503-706-9555
Mailing Address - Fax:
Practice Address - Street 1:32196 SW JOHNSON SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:OR
Practice Address - Zip Code:97113-6224
Practice Address - Country:US
Practice Address - Phone:503-706-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider