Provider Demographics
NPI:1073731238
Name:BARTOW, KIMBERLY ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:BARTOW
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 1:3551 WOODLAND LN
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:WI
Mailing Address - Zip Code:53811-9344
Mailing Address - Country:US
Mailing Address - Phone:608-748-5096
Mailing Address - Fax:
Practice Address - Street 1:18998 SCENIC VALLEY RD
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-8514
Practice Address - Country:US
Practice Address - Phone:608-647-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health