Provider Demographics
NPI:1588350201
Name:WEBBE, KIMBERLY JANICE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JANICE
Last Name:WEBBE
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 1:39 DAVENPORT AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3408
Mailing Address - Country:US
Mailing Address - Phone:607-342-4428
Mailing Address - Fax:
Practice Address - Street 1:301 S GENEVA ST APT 2B
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5463
Practice Address - Country:US
Practice Address - Phone:607-342-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY719103-1163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical