Provider Demographics
NPI:1437436953
Name:GOLDMACHER, KIMBERLY ANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:GOLDMACHER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANNE
Other - Last Name:BERK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, ANP-BC
Mailing Address - Street 1:103 PROGRESS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2511
Mailing Address - Country:US
Mailing Address - Phone:215-447-3630
Mailing Address - Fax:215-230-1943
Practice Address - Street 1:103 PROGRESS DR STE 300
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2511
Practice Address - Country:US
Practice Address - Phone:215-447-3630
Practice Address - Fax:215-230-1943
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011603363LA2200X
PASP014971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA054484Medicare PIN