Provider Demographics
NPI:1063684728
Name:CURTIS, KIMBERLY S (LPN)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:S
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 DAVEY MENDENHALL RD
Mailing Address - Street 2:
Mailing Address - City:HARPURSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13787-1844
Mailing Address - Country:US
Mailing Address - Phone:570-637-0092
Mailing Address - Fax:
Practice Address - Street 1:277 DAVEY MENDENHALL RD
Practice Address - Street 2:
Practice Address - City:HARPURSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13787-1844
Practice Address - Country:US
Practice Address - Phone:570-637-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283795-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse