Individual ProviderKimberly ClarkeRegistered NurseNursing Service ProvidersPractice Address42 Kennedy Ter, Middletown, NY 10940-4646(845) 321-9652PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Clarke does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1962937599Provider TypeIndividualFull NameClarke, KimberlyGenderFemaleSole ProprietorYesEnumeration Date4/20/2017Last Updated4/20/2017Contact InformationPractice LocationPractice Address42 Kennedy Ter, Middletown, NY 10940-4646Phone(845) 321-9652FaxUnlisted FaxMailing LocationMailing Address42 Kennedy Ter, Middletown, NY 10940-4646Phone(845) 321-9652FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense720729New York