Provider Demographics
NPI:1780973370
Name:KIMBALL, FRANCINE LORRAINE (RPH)
Entity type:Individual
Prefix:MRS
First Name:FRANCINE
Middle Name:LORRAINE
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 W CHINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83714-1468
Mailing Address - Country:US
Mailing Address - Phone:208-323-7036
Mailing Address - Fax:208-323-7033
Practice Address - Street 1:5425 W CHINDEN BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:ID
Practice Address - Zip Code:83714-1468
Practice Address - Country:US
Practice Address - Phone:208-323-7036
Practice Address - Fax:208-323-7033
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP50051835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist