Provider Demographics
NPI:1821406554
Name:KIMBERLING, ROBERT (FNP)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:KIMBERLING
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NNPTC CIR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-6314
Mailing Address - Country:US
Mailing Address - Phone:843-794-6903
Mailing Address - Fax:843-794-6904
Practice Address - Street 1:HOSPITAL AMERICANO BASE NAVAL DE ROTA
Practice Address - Street 2:APARADO DE CORREOS 33
Practice Address - City:ROTA
Practice Address - State:CADIZ
Practice Address - Zip Code:11530
Practice Address - Country:ES
Practice Address - Phone:314-727-3524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001034363LF0000X
CA806451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA806451OtherRN