Provider Demographics
NPI:1295961894
Name:KIMBERLIN, JANELLE MARIE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARIE
Last Name:KIMBERLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 INDIAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7480
Mailing Address - Country:US
Mailing Address - Phone:907-747-2801
Mailing Address - Fax:
Practice Address - Street 1:701 INDIAN RIVER RD
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7480
Practice Address - Country:US
Practice Address - Phone:907-747-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator