1326351032 NPI number — MS. KIMBERLY ANNE KUREY FNP

Table of content: MS. KIMBERLY ANNE KUREY FNP (NPI 1326351032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326351032 NPI number — MS. KIMBERLY ANNE KUREY FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUREY
Provider First Name:
KIMBERLY
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326351032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 MONTAUK AVE, 1ST FLOOR NEW LONDON CT 06320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW LONDON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-892-8195
Provider Business Mailing Address Fax Number:
608-892-8223

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 MONTAUK AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW LONDON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-892-8195
Provider Business Practice Location Address Fax Number:
608-892-8223
Provider Enumeration Date:
07/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  110189 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 336403 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 5330 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008086936 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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