Provider Demographics
NPI:1518779941
Name:CROSBY, KIMBERLEE JOY
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:JOY
Last Name:CROSBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 COUNTY ROAD 12 W
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-3004
Mailing Address - Country:US
Mailing Address - Phone:701-340-3125
Mailing Address - Fax:
Practice Address - Street 1:620 BAVARIA DR
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-1545
Practice Address - Country:US
Practice Address - Phone:701-838-5979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health