Healthcare Provider Details

I. General information

NPI: 1831464015
Provider Name (Legal Business Name): KAREE L. LEDEBOER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREE L. KIMBERLIN

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13414 E MISSION AVE
SPOKANE VALLEY WA
99216-2759
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-2326
  • Fax: 509-747-3040
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60277763
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN00163532
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60277763
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: