Provider Demographics
NPI:1184012429
Name:CADE, KIMBERLEY (PA)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:CADE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KIMBERLEY
Other - Middle Name:
Other - Last Name:KLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:616-486-6702
Practice Address - Street 1:4100 LAKE DR SE
Practice Address - Street 2:SUITE B01
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8292
Practice Address - Country:US
Practice Address - Phone:616-267-7400
Practice Address - Fax:616-267-7444
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant