Provider Demographics
NPI:1942972625
Name:SLIDER, KIMBERLY RAE (CRPN)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RAE
Last Name:SLIDER
Suffix:
Gender:F
Credentials:CRPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 S HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2022
Mailing Address - Country:US
Mailing Address - Phone:215-896-8938
Mailing Address - Fax:
Practice Address - Street 1:830 5TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4224
Practice Address - Country:US
Practice Address - Phone:717-709-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022644363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics