Provider Demographics
NPI:1659670941
Name:MAXFIELD, KIMBERLY A (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:MAXFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E RIDGEWAY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5060
Mailing Address - Country:US
Mailing Address - Phone:319-272-2388
Mailing Address - Fax:319-272-2077
Practice Address - Street 1:200 E RIDGEWAY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5060
Practice Address - Country:US
Practice Address - Phone:319-272-2388
Practice Address - Fax:319-272-2077
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086391163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse