Provider Demographics
NPI:1689267619
Name:KIMBALL HIGH PLAINS HEALTH LLC
Entity Type:Organization
Organization Name:KIMBALL HIGH PLAINS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-FNPBC
Authorized Official - Phone:970-846-5438
Mailing Address - Street 1:2 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KIMBALL
Mailing Address - State:NE
Mailing Address - Zip Code:69145-1326
Mailing Address - Country:US
Mailing Address - Phone:970-846-5438
Mailing Address - Fax:
Practice Address - Street 1:111 E 2ND ST
Practice Address - Street 2:
Practice Address - City:KIMBALL
Practice Address - State:NE
Practice Address - Zip Code:69145-1208
Practice Address - Country:US
Practice Address - Phone:970-846-5438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty