Provider Demographics
NPI:1578176616
Name:REMBLAKE, KIMBERLY NEHLS (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:NEHLS
Last Name:REMBLAKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6488 N ORACLE ROAD
Mailing Address - Street 2:
Mailing Address - City:TUSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704
Mailing Address - Country:US
Mailing Address - Phone:520-297-8397
Mailing Address - Fax:
Practice Address - Street 1:6488 N ORACLE ROAD
Practice Address - Street 2:
Practice Address - City:TUSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-297-8397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS011746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist