Provider Demographics
NPI:1912771296
Name:PARDO, KIMBERLYN (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLYN
Middle Name:
Last Name:PARDO
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 1:6 MEGAN LN
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL HALL
Mailing Address - State:NY
Mailing Address - Zip Code:10916-3319
Mailing Address - Country:US
Mailing Address - Phone:845-978-1388
Mailing Address - Fax:
Practice Address - Street 1:12 WATER ST APT 401
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1401
Practice Address - Country:US
Practice Address - Phone:914-216-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY704104-01163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health