Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 26NJ00980400 | NJ |
NPI | 1003450958 |
---|---|
Provider Name | Rhoda W Kimani |
First Address | Union, NJ 07083-6825 |
Second Address | Union, NJ 07083-6825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2019 |
Last Update Date | 20/11/2019 |