Provider Demographics
NPI:1942642426
Name:CAFARO, KIMBERLY (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:CAFARO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8062 NE 30TH PL
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-8849
Mailing Address - Country:US
Mailing Address - Phone:507-720-5500
Mailing Address - Fax:979-256-0890
Practice Address - Street 1:8062 NE 30TH PL
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-8849
Practice Address - Country:US
Practice Address - Phone:507-720-5500
Practice Address - Fax:979-256-0890
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5382363L00000X
CT005382363LP0808X
IAG121438363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA194-264-2426Medicaid
IA1942642426Medicaid