SUZETTE KIMBALL (NPI# 1174134894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174134894 |
| Entity Type | Individual |
| Full Name | SUZETTE KIMBALL |
| Credential | RN |
| Practice Address |
750 N Freedom Blvd Provo UT 84601-1677 |
| Practice Telephone | 8013734760 |
| Practice Fax Number | 8013730639 |
| Mailing Telephone | 8013734760 |
| Mailing Fax Number | 8013730639 |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
6978231-3102 | UT | Nursing Service Providers |
| Street Address |
750 N FREEDOM BLVD |
| City | PROVO |
| State | UT |
| Zip Code | 84601-1677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679551634 | Amy Buehler | Social Worker | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2006-01-09 |
| 1437750270 | Michael Stevenson | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-11-06 |
| 1174122683 | Alyssa Ketler | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-26 |
| 1770183261 | Kaitlin Buckway | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-26 |
| 1841899465 | Linda Madsen Fifita | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-23 |
| 1427657352 | Jessica Ray Clyde | Licensed Practical Nurse | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-21 |
| 1134728033 | Tyra Tsosie | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-21 |
| 1457950529 | Justin Jacobson | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-20 |
| 1881293264 | Kurt Louis Candalot | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-18 |
| 1265030613 | Ailaina Nicole Herman Rice | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205140951 | Shantel D Wilson | Registered Nurse | 750 N 200 W, Provo, UT 84601-1677 | 2010-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710538012 | Katherine Miller Cooper | Registered Nurse | 1708 N Trinnaman Ln, Lehi, UT 84043-3535 | 2019-09-27 |
| 1174707418 | Laraine N Sharpton | Registered Nurse | 6953 S 800 E, Midvale, UT 84047-1430 | 2007-12-21 |
| 1134215114 | Connie Jolene Winkel | Registered Nurse | 1658 N 1400 W Apt 2, Layton, UT 84041-1562 | 2006-10-05 |
| 1124048319 | Stella Blight | Registered Nurse | 500 S. Foothill Blvd, George Wahlen Vamc, Salt Lake City, UT 84109 | 2006-07-20 |
| 1629003900 | Helen L Stanhope | Registered Nurse | 1399 South 700 Easrt, Suite 17b, Salt Lake City, UT 84105 | 2006-07-12 |
| 1790727733 | Lisa Ann Jensen | Registered Nurse | Slc Va Health Care System, 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-06-12 |
| 1013987858 | Christine H Webb | Registered Nurse | 479 W 950 N, Centerville, UT 84014-1364 | 2006-01-24 |
| 1619955812 | John Richard Mitchell | Registered Nurse | 5965 South 900 East, Ste 240 Valley Mental Health Ad, Salt Lake City, UT 84121-1720 | 2006-01-06 |
| 1568449619 | Sue Ellen Fisher | Registered Nurse | 2994 Tolcate Ln, Salt Lake City, UT 84121-1529 | 2005-12-29 |
| 1134105364 | Lisa Jane Olsen | Registered Nurse | 361 E 1200 S Ste 201, Orem, UT 84058-6904 | 2005-12-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.