Provider Demographics
NPI:1700657053
Name:QUINN, KIMBERLY ELISABETH (RN, BSN, MBA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ELISABETH
Last Name:QUINN
Suffix:
Gender:F
Credentials:RN, BSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14110 TREGARON DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-3724
Mailing Address - Country:US
Mailing Address - Phone:402-827-5950
Mailing Address - Fax:
Practice Address - Street 1:14110 TREGARON DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-3724
Practice Address - Country:US
Practice Address - Phone:402-827-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE77325163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool