MEDICARE: KIMBERLY K PIENING PA-C

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	363A00000X	Physician Assistant	1659	NE

General Provider Information

NPI Number	:	1669734794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY K PIENING PA-C

Provider Business Mailing Address
First Line	:	PO BOX 860876
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-0876
Country	:	US
Telephone Number	:	402-483-8590
Fax Number	:	402-483-8599

Provider Business Practice Location Address
First Line	:	3540 VILLAGE DR STE 100
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-4706
Country	:	US
Telephone Number	:	402-483-3885
Fax Number	:

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

Provider Enumeration Date	:	06/14/2012
Last Update Date	:	02/04/2025

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Directions to “ KIMBERLY K PIENING PA-C” Practice Location

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