Kimball, Jacquelyn Renae

Kimball, Jacquelyn Renae is an individual health care provider with primary practice located at 421 N Main St , Leeds MA 01053-9764. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Kimball, Jacquelyn Renae can be contacted via phone (413) 584-4040.

Contact Information

Primary practice address
421 N Main St Leeds MA 01053-9764
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 51632 Connecticut
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 255263 Massachusetts

Profile Details

NPI number 1881822419
LBN Legal business name Kimball, Jacquelyn Renae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2009
Last updated Oct 10th, 2023 - about last year

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 1881822419 NPPES
Massachusetts Other 023060 MBHP
Massachusetts Other 61082 MBHP
Massachusetts Other J52483 MBHP

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