Provider Demographics
NPI:1164690517
Name:WINKLEY, KIMBERLY A (ARNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:WINKLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:17053 S 71 HWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012
Mailing Address - Country:US
Mailing Address - Phone:816-322-0688
Mailing Address - Fax:816-322-4722
Practice Address - Street 1:17053 S 71 HWY
Practice Address - Street 2:SUITE 203
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012
Practice Address - Country:US
Practice Address - Phone:816-322-0688
Practice Address - Fax:816-322-4722
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46168363LF0000X
MO2003020395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00616074OtherRR MEDICARE
KSP00616074OtherRR MEDICARE
MO115000001Medicare PIN
KS115A00002Medicare PIN