Provider Demographics
NPI:1811680994
Name:DOXEY, KIMBERLY JO (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JO
Last Name:DOXEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8453 JACLYN ANN DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2913
Mailing Address - Country:US
Mailing Address - Phone:231-349-8188
Mailing Address - Fax:
Practice Address - Street 1:8453 JACLYN ANN DR
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-2913
Practice Address - Country:US
Practice Address - Phone:231-349-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704306407163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator