Provider Demographics
NPI:1053046656
Name:ARMSTRONG, KIMBERLY DIANELL (RN, FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DIANELL
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 W 39TH PL
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-1908
Mailing Address - Country:US
Mailing Address - Phone:219-776-0337
Mailing Address - Fax:
Practice Address - Street 1:5800 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2601
Practice Address - Country:US
Practice Address - Phone:219-884-9180
Practice Address - Fax:219-884-9280
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28150365A363LF0000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily