Provider Demographics
NPI:1215272190
Name:TORGERSON, KIMBER LYNN (LPN)
Entity type:Individual
Prefix:MRS
First Name:KIMBER
Middle Name:LYNN
Last Name:TORGERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 GREENSTREET BLVD
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-1327
Mailing Address - Country:US
Mailing Address - Phone:360-855-3545
Mailing Address - Fax:
Practice Address - Street 1:719 GREENSTREET BLVD
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-1327
Practice Address - Country:US
Practice Address - Phone:360-855-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00046194164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse