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Individual
KIMBERLY MARIE RENO
Active
Individual
KIMBERLY MARIE RENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007055
GA
363A00000X
Physician Assistant
Primary
5601008333
MI
363A00000X
Physician Assistant
PA60679
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141282A
—
GA
05
—
003141282B
—
GA
05
—
003141282C
—
GA
01
—
P01264041
RAILROAD MEDICARE
GA
Enumeration date
11/07/2013
Last updated
02/02/2026
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