Provider Demographics
NPI:1386634244
Name:KIMBALL, AMY EVEREST (MS)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:EVEREST
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 N CHARLES ST
Mailing Address - Street 2:SUITE 2310
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6808
Mailing Address - Country:US
Mailing Address - Phone:443-849-2536
Mailing Address - Fax:443-849-2708
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 2310
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-2536
Practice Address - Fax:443-849-2708
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS