Provider Demographics
NPI:1932862844
Name:RAJEC, KIMBERLEE S
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:S
Last Name:RAJEC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3844 W CAMINO DEL RIO
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-4115
Mailing Address - Country:US
Mailing Address - Phone:623-703-0161
Mailing Address - Fax:
Practice Address - Street 1:3844 W CAMINO DEL RIO
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-4115
Practice Address - Country:US
Practice Address - Phone:623-703-0161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider