Provider Demographics
NPI:1518366764
Name:CAPES, KIMBERLY (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:CAPES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 SILVER BELL RD # 700
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3174
Mailing Address - Country:US
Mailing Address - Phone:651-350-7179
Mailing Address - Fax:
Practice Address - Street 1:1981 SILVER BELL RD # 700
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3174
Practice Address - Country:US
Practice Address - Phone:651-350-7179
Practice Address - Fax:651-350-7903
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor