Provider Demographics
NPI:1952149791
Name:KIMMEL, JAIMEE R
Entity type:Individual
Prefix:
First Name:JAIMEE
Middle Name:R
Last Name:KIMMEL
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 1:6213 E CALLE DE POMPAS
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-2512
Mailing Address - Country:US
Mailing Address - Phone:602-561-0440
Mailing Address - Fax:
Practice Address - Street 1:6213 E CALLE DE POMPAS
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-2512
Practice Address - Country:US
Practice Address - Phone:602-561-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach