Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 23911 | CA |
NPI | 1033362686 |
---|---|
Provider Name | April Lynn Kimp |
First Address | Redding, CA 96001-1125 |
Second Address | Redding, CA 96001-1125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RDH 23911 | RDH (01) | CA |