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KIMORA EBONEE BETHEA LPN
NPI 1720956907
Licensed Practical Nurse in New York, NY

Active since October 28, 2025
385 EDGECOMBE AVE APT 56, NEW YORK, NY 10031(646) 295-7541 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimora Ebonee Bethea Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMORA EBONEE BETHEA LPN (NPI 1720956907) is an individual licensed practical nurse in New York, New York, licensed in New York (354045) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1720956907
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKIMORA EBONEE BETHEACredential: LPN
Location Address385 EDGECOMBE AVE APT 56New York, NY 10031-1330
Mailing Address385 Edgecombe Ave Apt 56New York, NY 10031-1330
Phone(646) 295-7541
Sole ProprietorNo
Enumeration DateOctober 28, 2025
NPPES CertifiedOctober 28, 2025
✔ NPI 1720956907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 354045
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
385 EDGECOMBE AVE APT 56, New York, NY 10031
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimora Bethea's NPI number?

The NPI number for Kimora Bethea is 1720956907. It was assigned to this individual provider in the NPPES registry on October 28, 2025.

Where is Kimora Bethea located?

Kimora Bethea practices at 385 Edgecombe Ave Apt 56, New York, NY 10031. The listed phone number is (646) 295-7541.

What is Kimora Bethea's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kimora Bethea was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.