Doctor Name: | KIMBERLY JO MALONE |
NPI Number: | 1093147050 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 111557 |
Business Practice Address: | 3911 Avenue B Suite 2100 Scottsbluff, NE - 693614617 |
Business Phone Number: | 3086302920 |
Business Fax Number: | 3086301890 |
Mailing Address: | 508 P St, Po Box 704 BRIDGEPORT |
State: | NE |
Postal Code: | 693364033 |
Phone Number: | 7122510135 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2013 |
NPI Last Update Date: | 08/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 111557 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |