Provider Demographics
NPI:1275204349
Name:RAMIREZ, KIM JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:JO
Last Name:RAMIREZ
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 1:6534 ETIWANDA AVE
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91752-2611
Mailing Address - Country:US
Mailing Address - Phone:951-751-9885
Mailing Address - Fax:
Practice Address - Street 1:4105 BRIARGATE PKWY STE 125
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3482
Practice Address - Country:US
Practice Address - Phone:800-218-1059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1674821163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management