Provider Demographics
NPI:1083476196
Name:KIMES, KARA
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:KIMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56159 RIVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-1144
Mailing Address - Country:US
Mailing Address - Phone:888-537-5733
Mailing Address - Fax:
Practice Address - Street 1:56159 RIVERDALE DR
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1144
Practice Address - Country:US
Practice Address - Phone:888-537-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator