Provider Demographics
NPI:1265880504
Name:KANNAPEL, KIMBERLY (RMT-REIKIMASTER)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:KANNAPEL
Suffix:
Gender:F
Credentials:RMT-REIKIMASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CRABAPPLE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1407
Mailing Address - Country:US
Mailing Address - Phone:908-842-3381
Mailing Address - Fax:732-951-9460
Practice Address - Street 1:30 CRABAPPLE LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1407
Practice Address - Country:US
Practice Address - Phone:908-842-3381
Practice Address - Fax:732-951-9460
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ81-1340612172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker