Individual provider · Type 1 NPI

Kimberly Wallace, LRN

Registered Nurse · Kennett, MO

NPI number 1114249117 Active

Practice location

925 Highway V V
Kennett, MO 63857

Call (573) 888-5925 Map

Fax (573) 888-9365

Mailing address

500 US Highway 61 North
Hayti, MO 63851

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse Primary 163W00000X2007032845 (MO)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1114249117

Kimberly Wallace, LRN's National Provider Identifier is 1114249117, issued on Feb 18, 2010. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Kennett, MO. The record was last updated on Feb 18, 2010.