Jolly, Kim D

Jolly, Kim D is an individual health care provider with primary practice located at 3716 W Oakland Park Blvd , Lauderdale Lakes FL 33311-1134. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Jolly, Kim D can be contacted via phone (954) 759-7557.

Contact Information

Primary practice address
3716 W Oakland Park Blvd Lauderdale Lakes FL 33311-1134
Phone: (954) 759-7557
Fax: (954) 733-9155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2005522 Florida

Profile Details

NPI number 1831153733
LBN Legal business name Jolly, Kim D
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Apr 1st, 2024 - about 2 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 1831153733 NPPES
Florida MEDICAID 034297100

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