Provider Demographics
NPI:1760406425
Name:KIMERER, VIRGINIA L (ARNP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:L
Last Name:KIMERER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR
Mailing Address - Street 2:STE. 220
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:913-495-2220
Mailing Address - Fax:
Practice Address - Street 1:407 S CLAIRBORNE RD
Practice Address - Street 2:STE 103
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1723
Practice Address - Country:US
Practice Address - Phone:913-780-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q20015Medicare UPIN