Provider Demographics
NPI:1588047021
Name:BORNEMAN, KIMBERLEE KAY (CNM)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:KAY
Last Name:BORNEMAN
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5002 WILLOWBEND RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-6513
Mailing Address - Country:US
Mailing Address - Phone:319-431-7867
Mailing Address - Fax:
Practice Address - Street 1:146 W DALE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1901
Practice Address - Country:US
Practice Address - Phone:319-235-5050
Practice Address - Fax:319-235-5107
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB109170367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife