Provider Demographics
NPI:1851585889
Name:CHRISTIANSEN, KIMBERLY SUE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUE
Last Name:CHRISTIANSEN
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 1:4579 25TH CT SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-7815
Mailing Address - Country:US
Mailing Address - Phone:239-692-8621
Mailing Address - Fax:
Practice Address - Street 1:5440 PARK CENTRAL CT
Practice Address - Street 2:SUITE B
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-5923
Practice Address - Country:US
Practice Address - Phone:239-597-7118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3223652163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health