Provider Demographics
NPI:1073725867
Name:VALENTINE, KIMBERLY ANN (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 W EUGIE AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1234
Mailing Address - Country:US
Mailing Address - Phone:602-298-8888
Mailing Address - Fax:602-938-2504
Practice Address - Street 1:5605 W EUGIE AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1234
Practice Address - Country:US
Practice Address - Phone:602-298-8888
Practice Address - Fax:602-938-2504
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN125917163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic