Otter, Kimberly M

Otter, Kimberly M is an individual health care provider with primary practice located at 935 Jersey St , Quincy IL 62301-4030. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Otter, Kimberly M can be contacted via phone (217) 228-2413.

Contact Information

Primary practice address
935 Jersey St Quincy IL 62301-4030
Phone: (217) 228-2413
Fax: (217) 228-2416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 2004029302 Missouri
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X Illinois

Profile Details

NPI number 1245232909
LBN Legal business name Otter, Kimberly M
Credentials RD LDN
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Jul 8th, 2007 - about 18 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 1245232909 NPPES
Illinois Other 075113 QUINCY HEALTH CARE MGMT.
Illinois Other 000009329891 QUINCY HEALTH CARE MGMT.
Illinois Other 00132009 QUINCY HEALTH CARE MGMT.

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