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Kimberly Anne Mcclintic

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

9900 Bren Rd E, Minnetonka, MN 55343-9664

PECOS Enrollment

Based on the most recent information from CMS, provider Kimberly Anne Mcclintic does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1518152511
Provider Type
Individual
Full Name
Mcclintic, Kimberly Anne
Title
Mrs.
Credential
F.N.P.-C

Gender
Female
Sole Proprietor
No
Enumeration Date
9/12/2007
Last Updated
6/29/2020

Contact Information

Practice Location

9900 Bren Rd E, Minnetonka, MN 55343-9664

(480) 865-4839

Unlisted Fax

Mailing Location

7814 E Granada Rd, Scottsdale, AZ 85257-2247

(480) 865-4839

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP2746 Arizona
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP2746 Arizona

Provider Identifiers

ID	Description	Issuer
ID 275028	Description Medicaid	Issuer Unlisted Arizona

Kimberly Anne Mcclintic

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Stone, Cristina

Gutierrez, Lia Sloan

Kainer, Jennifer K.

Hardman, Angela Faye

Vallin, Marta Hernandez

Pennicooke, Denise

Serdynski, Georgetta S

Schaefer, Dawn M

Berry, Wakiya

Cope, Heather L.