Provider Demographics
NPI:1851764427
Name:WIMBERLEY, RHIANNA COLETTE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:RHIANNA
Middle Name:COLETTE
Last Name:WIMBERLEY
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:RHIANNA
Other - Middle Name:
Other - Last Name:NAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:5079 WESTERN BLVD
Mailing Address - Street 2:2G
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7185
Mailing Address - Country:US
Mailing Address - Phone:503-975-0055
Mailing Address - Fax:
Practice Address - Street 1:5079 WESTERN BLVD
Practice Address - Street 2:2G
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7185
Practice Address - Country:US
Practice Address - Phone:503-975-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201041756RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse