Provider Demographics
NPI:1396569752
Name:LINDEMAN, KIMBERLY RAE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RAE
Last Name:LINDEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 S AUTUMN CT
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-5253
Mailing Address - Country:US
Mailing Address - Phone:307-660-3463
Mailing Address - Fax:
Practice Address - Street 1:2115 S AUTUMN CT
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-5253
Practice Address - Country:US
Practice Address - Phone:307-660-3463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program