Provider Demographics
NPI:1821894098
Name:TUNSTALL, KIMBERLY (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:TUNSTALL
Suffix:
Gender:
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 S 84TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2558
Mailing Address - Country:US
Mailing Address - Phone:414-940-2768
Mailing Address - Fax:
Practice Address - Street 1:2311 S 84TH ST APT 1
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2558
Practice Address - Country:US
Practice Address - Phone:414-940-2768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health