Provider Demographics
NPI:1275842684
Name:RANIERI, KIMBERLY MARIE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MARIE
Last Name:RANIERI
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:161 DODD BLVD
Mailing Address - Street 2:
Mailing Address - City:LANGLEY AFB
Mailing Address - State:VA
Mailing Address - Zip Code:23665-1928
Mailing Address - Country:US
Mailing Address - Phone:210-517-1487
Mailing Address - Fax:
Practice Address - Street 1:2304 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3115
Practice Address - Country:US
Practice Address - Phone:757-951-1579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-03
Last Update Date:2021-02-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant