Provider Demographics
NPI:1467775056
Name:JASCH, KIMBERLY D (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:D
Last Name:JASCH
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:700 8TH AVE W
Mailing Address - Street 2:STE 101
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4008
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:5460 63RD ST E
Practice Address - Street 2:STE 200 B
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-7808
Practice Address - Country:US
Practice Address - Phone:941-316-8200
Practice Address - Fax:941-316-8199
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2017-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP2732962363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology