| Doctor Name: | KIMBERLY RAE MOL |
| NPI Number: | 1073750485 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 4704201722 |
| Business Practice Address: | 14928 16 Mile Rd Leroy, MI - 496558293 |
| Business Phone Number: | 2317684675 |
| Business Fax Number: | |
| Mailing Address: | 10879 Riley St, ZEELAND |
| State: | MI |
| Postal Code: | 494646857 |
| Phone Number: | 6163666875 |
| Fax Number: | |
| NPI Enumeration Date: | 01/07/2009 |
| NPI Last Update Date: | 01/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 4704201722 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |