Provider Demographics
NPI:1740309400
Name:FURTADO, KIMBERLY D (ND)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:FURTADO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35252 HUDSON WAY
Mailing Address - Street 2:UNIT 2
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971
Mailing Address - Country:US
Mailing Address - Phone:302-945-2107
Mailing Address - Fax:302-945-2107
Practice Address - Street 1:35252 HUDSON WAY
Practice Address - Street 2:UNIT 2
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971
Practice Address - Country:US
Practice Address - Phone:302-945-2107
Practice Address - Fax:302-945-2107
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0990000082175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath