Provider Demographics
NPI:1023835865
Name:EBEL, KIMBERLY (RN, PCD(DONA))
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:EBEL
Suffix:
Gender:F
Credentials:RN, PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WOODSIDE TER
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5024
Mailing Address - Country:US
Mailing Address - Phone:201-956-0704
Mailing Address - Fax:
Practice Address - Street 1:43 WOODSIDE TER
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5024
Practice Address - Country:US
Practice Address - Phone:201-956-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16771200163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant