Provider Demographics
NPI:1366909996
Name:KARIMI MORISETT, KIMBERLY ANNE (CGP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:KARIMI MORISETT
Suffix:
Gender:F
Credentials:CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 E WALTON RD
Mailing Address - Street 2:
Mailing Address - City:SHEPHERD
Mailing Address - State:MI
Mailing Address - Zip Code:48883-9563
Mailing Address - Country:US
Mailing Address - Phone:989-773-5060
Mailing Address - Fax:
Practice Address - Street 1:4680 E WALTON RD
Practice Address - Street 2:
Practice Address - City:SHEPHERD
Practice Address - State:MI
Practice Address - Zip Code:48883-9563
Practice Address - Country:US
Practice Address - Phone:989-773-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator