Provider Demographics
NPI:1265670566
Name:FOUCHE, KIMBERLY JOYCE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JOYCE
Last Name:FOUCHE
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 1:19530 CHERRY HILL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5314
Mailing Address - Country:US
Mailing Address - Phone:248-632-4356
Mailing Address - Fax:
Practice Address - Street 1:19530 CHERRY HILL ST
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5314
Practice Address - Country:US
Practice Address - Phone:248-632-4356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704269153163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse