Kimball, Beverly A.

Kimball, Beverly A. is an individual health care provider with primary practice located at 1700 W Stout St , Rice Lake WI 54868-5000. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Kimball, Beverly A. can be contacted via phone (715) 236-8100.

Contact Information

Primary practice address
1700 W Stout St Rice Lake WI 54868-5000
Phone: (715) 236-8100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 8905 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 225-023 Wisconsin

Profile Details

NPI number 1245293463
LBN Legal business name Kimball, Beverly A.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 7th, 2010 - about 16 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 1245293463 NPPES
Minnesota MEDICAID 843159100
Minnesota MEDICAID 41935200

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