Healthcare Provider Details

I. General information

NPI: 1669734794
Provider Name (Legal Business Name): KIMBERLY K PIENING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY K SALBER PA-C

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 VILLAGE DR STE 100
LINCOLN NE
68516-4706
US

IV. Provider business mailing address

PO BOX 860876
MINNEAPOLIS MN
55486-0876
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-3885
  • Fax:
Mailing address:
  • Phone: 402-483-8590
  • Fax: 402-483-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1659
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: