| Provider / Organization | NPI | Date Certified |
|---|---|---|
| PORSHAE KIMBLE | 1790384188 | 2020-10-18 |
Porshae Kimble is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1790384188. Registration indicates Porshae Kimble is a provider of services with a specialization in Nursing Service Related Providers, Nurses Aide (Nurses Aide, ) (Nurses Aide, Nursing Service Related Providers) (Nurses Aide, )
| Entity Type | Individual |
| Provider Name | Porshae Kimble ADULT FAMILY HOME |
| Practice Office Address | 4428 W LLOYD ST MILWAUKEE, WI US |
| Practice Office Telephone | 4143953360 |
| Mailing Address | 4428 W LLOYD ST MILWAUKEE, WI 532081207 US |
| Business Telephone | 4143953360 |
| Code | Practice | License No State |
|---|---|---|
| 376K00000X PRIMARY | Nursing Service Related Providers Nurses Aide Nurses Aide Nurses Aide Nursing Service Related Providers Nurses Aide | 30311
WI |