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NPI Profile for KIMBERLEY F GANGWISH in GRAND ISLAND, NE.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1598768046 |
|
| Status | Active | |
| Credentials | PA (Physician Assistant) | |
| Entity | Individual | |
| Enumeration date | 05/28/2005 | |
| Last updated | 10/02/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KIMBERLEY F GANGWISH
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KIMBERLEY F GANGWISH, PA