Provider Demographics
NPI:1376356147
Name:RASHADA, KIMBERLEY LOUISE (BS)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:LOUISE
Last Name:RASHADA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40042 CAMBRIDGE ST APT 101
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4540
Mailing Address - Country:US
Mailing Address - Phone:734-877-0122
Mailing Address - Fax:888-841-7085
Practice Address - Street 1:40042 CAMBRIDGE ST APT 101
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4540
Practice Address - Country:US
Practice Address - Phone:734-877-0122
Practice Address - Fax:888-841-7085
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider