Provider Demographics
NPI:1952384919
Name:KIMBERLING, RENEE CAROL (FNP)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:CAROL
Last Name:KIMBERLING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1543 COLONY WAY
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-4162
Mailing Address - Country:US
Mailing Address - Phone:951-222-8150
Mailing Address - Fax:951-222-8815
Practice Address - Street 1:4800 MAGNOLIA AVE
Practice Address - Street 2:RCC HEALTH SERVICES
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1299
Practice Address - Country:US
Practice Address - Phone:951-222-8150
Practice Address - Fax:951-222-8815
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP12027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily