Individual
MS. KIMBERLEY ELIZABETH WENGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1601 E 4TH PLAIN BLVD, V3-HBPC, VANCOUVER, WA 98661
(360) 905-1749
(360) 690-0343
Mailing address
36006 BRYANT DR SW, ALBANY, OR 97321-1853
(303) 895-7076
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
77745
CO
363LC1500X
Community Health Nurse Practitioner
77745
CO
363LF0000X
Family Nurse Practitioner
Primary
77745
CO
363LG0600X
Gerontology Nurse Practitioner
77745
CO
363LP2300X
Primary Care Nurse Practitioner
77745
CO
Other
Enumeration date
07/08/2006
Last updated
07/29/2022
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