Healthcare Provider Details

I. General information

NPI: 1326023656
Provider Name (Legal Business Name): KIMBERLY NEUMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY HANSEN MD

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 FRANKLIN ST
WATERLOO IA
50703-4407
US

IV. Provider business mailing address

905 FRANKLIN ST
WATERLOO IA
50703-4407
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-4300
  • Fax:
Mailing address:
  • Phone: 319-874-3000
  • Fax: 319-874-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number28834
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: