Provider Demographics
NPI:1538981725
Name:KIMANI, WINFRED
Entity type:Individual
Prefix:
First Name:WINFRED
Middle Name:
Last Name:KIMANI
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 1:169 MOORE ST UNIT 15
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-5063
Mailing Address - Country:US
Mailing Address - Phone:978-327-8746
Mailing Address - Fax:
Practice Address - Street 1:169 MOORE ST UNIT 15
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-5063
Practice Address - Country:US
Practice Address - Phone:978-327-8746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2345828163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse