Provider Demographics
NPI:1639372329
Name:TRILLING, KIERSTEN M (CRNP)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:M
Last Name:TRILLING
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 1:442 LEWISTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:JULIUSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08042-0295
Mailing Address - Country:US
Mailing Address - Phone:609-894-2078
Mailing Address - Fax:
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:2 MAIN BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:267-426-4078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008461363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal