Provider Demographics
NPI:1669119954
Name:KIMBALL, ASHLYNN (MGC)
Entity type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:MGC
Other - Prefix:
Other - First Name:ASHLYNN
Other - Middle Name:
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MGC
Mailing Address - Street 1:1175 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-2325
Mailing Address - Country:US
Mailing Address - Phone:858-829-4181
Mailing Address - Fax:
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS