Doctor Name: | KIMBERLY PRINCESS RADER |
NPI Number: | 1083834907 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | PN1059411 |
Business Practice Address: | 37944 Church Ave Dade City, FL - 33525 |
Business Phone Number: | 3525182000 |
Business Fax Number: | 3525675193 |
Mailing Address: | Po Box 232, DADE CITY |
State: | FL |
Postal Code: | 33526 |
Phone Number: | 3525182000 |
Fax Number: | 3525675193 |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | PN1059411 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |