Provider Demographics
NPI:1063236784
Name:KIMBROUGH, ZEYRIA DEWITT
Entity type:Individual
Prefix:MS
First Name:ZEYRIA
Middle Name:DEWITT
Last Name:KIMBROUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8410 BRAILE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-2808
Mailing Address - Country:US
Mailing Address - Phone:313-400-7877
Mailing Address - Fax:
Practice Address - Street 1:8410 BRAILE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-2808
Practice Address - Country:US
Practice Address - Phone:313-400-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No174200000XOther Service ProvidersMeals