Provider Demographics
NPI:1669465019
Name:TULL, KIMBERLY E (ATC, NREMT-P)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:TULL
Suffix:
Gender:F
Credentials:ATC, NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 EDEN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2151
Mailing Address - Country:US
Mailing Address - Phone:410-677-6523
Mailing Address - Fax:
Practice Address - Street 1:222 EDEN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2151
Practice Address - Country:US
Practice Address - Phone:410-677-6523
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer