Kimball, Diane Marie

Kimball, Diane Marie is an individual health care provider with primary practice located at 920 Country Club Rd Suite 200A, Eugene OR 97401-6024. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kimball, Diane Marie can be contacted via phone (541) 342-2134.

Contact Information

Primary practice address
920 Country Club Rd Suite 200A Eugene OR 97401-6024
Fax: (541) 686-6021
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200850098NP Oregon

Profile Details

NPI number 1083603575
LBN Legal business name Kimball, Diane Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Oct 28th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083603575 NPPES
Oregon MEDICAID 270944

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