Provider Demographics
NPI:1700100518
Name:DESCH, KIM L (BSN, NP)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:L
Last Name:DESCH
Suffix:
Gender:F
Credentials:BSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 VILLAGE DR APT 105
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8150
Mailing Address - Country:US
Mailing Address - Phone:858-682-4078
Mailing Address - Fax:
Practice Address - Street 1:700 GARDEN VIEW CT
Practice Address - Street 2:STE., 200
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2478
Practice Address - Country:US
Practice Address - Phone:858-682-4078
Practice Address - Fax:760-634-2589
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436897363LW0102X
CA6518363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health