Individual provider · Type 1 NPI

Kimora Ebonee Bethea, LPN

Licensed Practical Nurse · New York, NY

NPI number 1720956907 Active

Practice location

385 Edgecombe Ave Apt 56
New York, NY 10031-1330

Call (646) 295-7541 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X354045 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1720956907

Kimora Ebonee Bethea, LPN's National Provider Identifier is 1720956907, issued on Oct 28, 2025. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in New York, NY. The record was last updated on Oct 28, 2025.