Provider Demographics
NPI:1225029846
Name:KIMBLER, DONALD E JR (CRNA, PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:KIMBLER
Suffix:JR
Gender:M
Credentials:CRNA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 3310
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09094-3310
Mailing Address - Country:US
Mailing Address - Phone:314-590-5140
Mailing Address - Fax:
Practice Address - Street 1:UNIT 3310
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09094-3310
Practice Address - Country:US
Practice Address - Phone:314-590-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN185936163WA2000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator