Provider Demographics
NPI:1184029084
Name:KIMKARE2U
Entity Type:Organization
Organization Name:KIMKARE2U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:BRENNAN
Authorized Official - Last Name:WEIERHEISER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-858-1133
Mailing Address - Street 1:8615 ARDENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5337
Mailing Address - Country:US
Mailing Address - Phone:727-858-1133
Mailing Address - Fax:
Practice Address - Street 1:8615 ARDENWOOD CT
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5337
Practice Address - Country:US
Practice Address - Phone:727-858-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNPFO313216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty