Provider Demographics
NPI:1629265731
Name:KAUMEHEIWA, KIMBERLY E (NP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:KAUMEHEIWA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:E
Other - Last Name:WENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:UNITEDHEALTH GROUP
Mailing Address - Street 2:9900 BREN ROAD EAST, MN 008-B213,
Mailing Address - City:MINNITONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343
Mailing Address - Country:US
Mailing Address - Phone:808-366-0800
Mailing Address - Fax:
Practice Address - Street 1:UNITEDHEALTH GROUP
Practice Address - Street 2:9900 BREN ROAD EAST, MN 008-B213,
Practice Address - City:MINNITONKA
Practice Address - State:MN
Practice Address - Zip Code:55343
Practice Address - Country:US
Practice Address - Phone:808-366-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17417363L00000X
HI1112 NP15363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1112OtherSTATE LICENSE
CA17417OtherSTATE LICENSE