KIMBERLY C PENDLETON CRNA
NPI 1215920376
Nurse Anesthetist, Certified Registered in Johnson City, TN

Q: What is Kimberly Pendleton's NPI number?

The NPI number for Kimberly Pendleton is 1215920376. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Q: What is Kimberly Pendleton's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since August 24, 2005

1009 LARK ST, SUITE 2, JOHNSON CITY, TN 37604(423) 283-0776(423) 283-0549 Get Directions Write a Review

NPPES record last updated: May 9, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kimberly C Pendleton Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY C PENDLETON CRNA (NPI 1215920376) is an individual nurse anesthetist, certified registered in Johnson City, Tennessee, licensed in Tennessee (RN0000049997) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1215920376

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameKIMBERLY C PENDLETONCredential: CRNA

Location Address1009 LARK ST, SUITE 2Johnson City, TN 37604-8217

Mailing AddressPo Box 3727Johnson City, TN 37602-3727 · (423) 283-0776 · Fax (423) 283-0549

Phone(423) 283-0776

Fax(423) 283-0549

Sole ProprietorNo

Enumeration DateAugust 24, 2005

Last NPPES UpdateMay 9, 2013

✔ NPI 1215920376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in TN · RN0000049997

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

1009 LARK ST, Johnson City, TN 37604

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Other Identifiers 2

Medicaid3602812TN

Medicare ID-Type Unspecified3602816TN

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA W GREEN CRNA