Barracco, Kimberley Lis

Barracco, Kimberley Lis is an individual health care provider with primary practice located at 12 Kanawha Ter , Saint Albans WV 25177-2750. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Barracco, Kimberley Lis can be contacted via phone (304) 757-6999.

Contact Information

Primary practice address
12 Kanawha Ter Saint Albans WV 25177-2750
Phone: (304) 757-6999
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 39076 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2064 West Virginia

Profile Details

NPI number 1700984366
LBN Legal business name Barracco, Kimberley Lis
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Sep 18th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700984366 NPPES
Other 001879423 BLUE CROSS BLUE SHEILD
Other 7070869 BLUE CROSS BLUE SHEILD
MEDICAID 390767 BLUE CROSS BLUE SHEILD
Other SCC510H895 BLUE CROSS BLUE SHEILD
MEDICAID 3810005951 BLUE CROSS BLUE SHEILD

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