Provider Demographics
NPI:1942262456
Name:KAMBIC, ANNA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:KAMBIC
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:CATALANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:225 N FRONT ST
Practice Address - Street 2:
Practice Address - City:STEELTON
Practice Address - State:PA
Practice Address - Zip Code:17113-2240
Practice Address - Country:US
Practice Address - Phone:717-939-4593
Practice Address - Fax:717-939-0955
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN233384L163W00000X
PA004179363L00000X
PAVP004679B363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0073661090002Medicaid
PA0073661090002Medicaid
PAS48619Medicare UPIN