Provider Demographics
NPI:1568109320
Name:HYMEL, KIM C (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:C
Last Name:HYMEL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72079 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ABITA SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70420-3625
Mailing Address - Country:US
Mailing Address - Phone:985-892-2070
Mailing Address - Fax:
Practice Address - Street 1:72079 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ABITA SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70420-3625
Practice Address - Country:US
Practice Address - Phone:985-892-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN097973163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool