Provider Demographics
NPI:1174245682
Name:BRENNEMAN, KIMBERLY (ARNP, CNM)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:BRENNEMAN
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2991 310TH ST
Mailing Address - Street 2:
Mailing Address - City:PARNELL
Mailing Address - State:IA
Mailing Address - Zip Code:52325-8836
Mailing Address - Country:US
Mailing Address - Phone:319-325-9348
Mailing Address - Fax:
Practice Address - Street 1:408 C AVE
Practice Address - Street 2:
Practice Address - City:KALONA
Practice Address - State:IA
Practice Address - Zip Code:52247-9742
Practice Address - Country:US
Practice Address - Phone:319-325-9348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB170998367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife