Provider Demographics
NPI:1245030584
Name:WIMBERLEY, JOSHUA CAINE (NRP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CAINE
Last Name:WIMBERLEY
Suffix:
Gender:M
Credentials:NRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6916 KING RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-2206
Mailing Address - Country:US
Mailing Address - Phone:432-230-9995
Mailing Address - Fax:
Practice Address - Street 1:6916 KING RANCH RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-2206
Practice Address - Country:US
Practice Address - Phone:432-230-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8047896146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic