MEDICARE: KIMBERLY RENEE HINTON NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9244102	FL

General Provider Information

NPI Number	:	1629484175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY RENEE HINTON NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	408 S 1ST ST
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-4146
Country	:	US
Telephone Number	:	863-354-1394
Fax Number	:	863-638-5722

Provider Business Practice Location Address
First Line	:	408 S 1ST ST
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-4146
Country	:	US
Telephone Number	:	863-353-1394
Fax Number	:	863-638-5722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2014
Last Update Date	:	01/05/2026

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