Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | OR | |
N | 363LN0000X | Nurse Practitioner - Neonatal | AP30006164 | WA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | OR | |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP30006164 | WA |
NPI | 1346354388 |
---|---|
Provider Name | Kimberly D Vanwinkle |
First Address | Puyallup, WA 98375-6685 |
Second Address | Seattle, WA 98122-4379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |