Provider Demographics
NPI:1730602012
Name:ARENBURG, KIMBERLY S (LPN)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:S
Last Name:ARENBURG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 CONWAY RD APT 337
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-4317
Mailing Address - Country:US
Mailing Address - Phone:321-225-9145
Mailing Address - Fax:
Practice Address - Street 1:2452 S. CONWAY RD
Practice Address - Street 2:APT 337
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812
Practice Address - Country:US
Practice Address - Phone:321-225-9145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5193429164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse