Provider Demographics
NPI:1962802264
Name:HILDEBRANT, KIMBERLY A (ARNP FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:HILDEBRANT
Suffix:
Gender:F
Credentials:ARNP FNP-C
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP FNP-C
Mailing Address - Street 1:1784 BELLA LAGO DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-4636
Mailing Address - Country:US
Mailing Address - Phone:352-708-4458
Mailing Address - Fax:
Practice Address - Street 1:2020 OAKLEY SEAVER DR STE 1
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1902
Practice Address - Country:US
Practice Address - Phone:352-404-7718
Practice Address - Fax:352-404-7723
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9237789363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHX268ZMedicare PIN