Provider Demographics
NPI:1639953441
Name:KIMBALL, MARGARET KATHLEEN (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5552 CRIBARI CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1314
Mailing Address - Country:US
Mailing Address - Phone:650-773-0372
Mailing Address - Fax:
Practice Address - Street 1:5552 CRIBARI CIR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-1314
Practice Address - Country:US
Practice Address - Phone:650-773-0372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431825364SF0001X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty