Provider Demographics
NPI:1598326787
Name:JOFFE, KIMBERLY H (CRNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:H
Last Name:JOFFE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 WALNUT ST STE 1414
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3610
Mailing Address - Country:US
Mailing Address - Phone:267-358-6155
Mailing Address - Fax:
Practice Address - Street 1:30 S VALLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1450
Practice Address - Country:US
Practice Address - Phone:267-358-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN661231163WE0003X
PASP020756363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency