National Provider Identifier Database

KIMBERLY A BERTHOLD, RN, BC, FNP – NPI #1780825570
Family


Contact Information

KIMBERLY A BERTHOLD, RN, BC, FNP
20 NE SAINT LUKES BLVD
SUITE 240
LEE'S SUMMIT, MO64086-6001
Phone: 816-931-1883
Fax: 816-756-3645
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for KIMBERLY A BERTHOLD

NPI Number 1780825570
Credentials RN, BC, FNP
Entity Individual
Enumeration date 03/09/2009
Last updated 05/08/2012 - About 14 years ago
Sole proprietor1 No
Identifiers
  • MO License #: 2008001025
  • KS Medicaid: 200258340D
  • KS Medicaid: 200258340E
  • MO Medicaid: 1780825570
  • KS Other: P00842733 RAILROAD MEDICARE
  • MO Other: P00836071 RAILROAD MEDICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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