Provider Demographics
NPI:1063913218
Name:ZIMBA, KIMBERLY MAUREEN (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MAUREEN
Last Name:ZIMBA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25418 S 187TH AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-4631
Mailing Address - Country:US
Mailing Address - Phone:623-687-0518
Mailing Address - Fax:
Practice Address - Street 1:25418 S 187TH AVE
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-4631
Practice Address - Country:US
Practice Address - Phone:623-687-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN187113163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool