Basic Information
Provider Information
NPI: 1790372712
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAPLIN
FirstName: KIMBERLY
MiddleName: MAE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1702 UNIVERSITY DR S
Address2:  
City: FARGO
State: ND
PostalCode: 581034940
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4110 51ST AVE S
Address2:  
City: FARGO
State: ND
PostalCode: 581047776
CountryCode: US
TelephoneNumber: 7013643100
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/23/2020
LastUpdateDate: 12/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X7652MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000XR43012NDY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home