Provider Demographics
NPI:1487104451
Name:NABAL, KIMBERLY (RNFA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:NABAL
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 KLEIN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-1713
Mailing Address - Country:US
Mailing Address - Phone:716-568-6100
Mailing Address - Fax:
Practice Address - Street 1:215 KLEIN RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-1713
Practice Address - Country:US
Practice Address - Phone:716-568-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY595427163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant