Kimberly A Jividen (NPI# 1205242369, PAC ID# 9830317650) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1205242369 |
| PAC ID by PECOS | 9830317650 |
| Professional Enrollment ID | I20140820000404 |
| Full Name | Kimberly A Jividen |
| Organization Legal Name | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| Address |
920 Elm St Racine OH 45771-8902 |
| Phone Number | 7409492348 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7810806577 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 511303 | MINNIE HAMILTON HEALTH SYSTEM |
| 510058 | CAMDEN CLARK MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 461 Schoolview St, Elizabeth, WV 21643 | 3042753117 | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| 2610 Camden Ave, Parkersburg, WV 26101-5652 | 3049173733 | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| 3705 Emerson Ave, Parkersburg, WV 26104-1118 | 3049173733 | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| 920 Elm St, Racine, OH 45771-8902 | 7409492348 | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| 562 Charleston Dr, Ripley, WV 25271-1533 | 3043727341 | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| Organization Legal Name | WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Junetta A Maynard | Nurse Practitioner | Wirt County Health Services Association, Inc | 920 Elm St, Racine, OH 45771-8902 |
| Heather J Kay | Nurse Practitioner | Wirt County Health Services Association, Inc | 2610 Camden Ave, Parkersburg, WV 26101-5652 |
| Murrita Bolinger | Nurse Practitioner | Wirt County Health Services Association, Inc | 461 Schoolview St, Elizabeth, WV 21643 |
| Timothy P Metzger | Family Medicine | Wirt County Health Services Association, Inc | 562 Charleston Dr, Ripley, WV 25271-1533 |
| Cherrie Cowan | Nurse Practitioner | Wirt County Health Services Association, Inc | 2610 Camden Ave, Parkersburg, WV 26101-5652 |
| Jessica Elaine Wooten | Nurse Practitioner | Wirt County Health Services Association, Inc | 461 Schoolview St, Elizabeth, WV 21643 |
| Amanda R Lynch | Nurse Practitioner | Wirt County Health Services Association, Inc | 2610 Camden Ave, Parkersburg, WV 26101-5652 |
| Miranda S Boso | Nurse Practitioner | Wirt County Health Services Association, Inc | 2610 Camden Ave, Parkersburg, WV 26101-5652 |
| Sireesha Dasari | Family Medicine | Wirt County Health Services Association, Inc | 2610 Camden Ave, Parkersburg, WV 26101-5652 |
| Bonnie Heather Templeton | Family Medicine | Wirt County Health Services Association, Inc | 461 Schoolview St, Elizabeth, WV 21643 |
| Street Address |
920 ELM ST |
| City | RACINE |
| State | OH |
| Zip | 45771-8902 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Junetta A Maynard | Nurse Practitioner | Wirt County Health Services Association, Inc | 920 Elm St, Racine, OH 45771-8902 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicole Rae Humphrey | Nurse Practitioner | Athens Medical Associates, LLC | 207 5th St, Racine, OH 45771-5012 |
| Douglas D Hunter | Family Medicine | Athens Medical Associates, LLC | 207 5th St, Racine, OH 45771-5012 |
| Melanie A Weese | Optometry | 109 N 3rd St, Racine, OH 45771-9552 |
| City | RACINE |
| Zip Code | 45771 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | RACINE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kimberly A Jividen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.