Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimora Ebonee Bethea, LPN

Individual provider Licensed Practical Nurse · NPI 1720956907

Kimora Ebonee Bethea, LPN is a Licensed Practical Nurse in New York, New York. Licensed in New York. Registered with an NPI since 2025.

Licensed in
NY
In the registry since
2025
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

385 Edgecombe Ave Apt 56
New York, NY 10031-1330
Phone: (646) 295-7541
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 354045 (NY)

Record details

NPI number1720956907
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPN
Sole proprietorNo
NPI enumeratedOctober 28, 2025
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

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