Provider Demographics
NPI:1942261995
Name:BINA, KIMBERLY C (DO)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:C
Last Name:BINA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:C
Other - Last Name:BOERSMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2214 SW RIDGEWAY CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-5424
Mailing Address - Country:US
Mailing Address - Phone:515-963-5450
Mailing Address - Fax:
Practice Address - Street 1:2214 SW RIDGEWAY CT
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-5424
Practice Address - Country:US
Practice Address - Phone:515-963-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7671207Q00000X
IL036-111283207Q00000X
IA3467207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H77460Medicare UPIN