Provider Demographics
NPI:1982591236
Name:KIMBEL, JODIE L (DIRECTOR)
Entity type:Individual
Prefix:MS
First Name:JODIE
Middle Name:L
Last Name:KIMBEL
Suffix:
Gender:F
Credentials:DIRECTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-9727
Mailing Address - Country:US
Mailing Address - Phone:585-404-6203
Mailing Address - Fax:
Practice Address - Street 1:25 E STATE ST
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-9727
Practice Address - Country:US
Practice Address - Phone:585-404-6203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care