Provider Demographics
NPI:1295592699
Name:NELSON, KIMBERLY ANNE (DNP, CNS, RN ACNS-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:NELSON
Suffix:
Gender:F
Credentials:DNP, CNS, RN ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 BRADFORD PARK RD
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-2405
Mailing Address - Country:US
Mailing Address - Phone:540-226-7533
Mailing Address - Fax:
Practice Address - Street 1:213 BRADFORD PARK RD
Practice Address - Street 2:
Practice Address - City:BADEN
Practice Address - State:PA
Practice Address - Zip Code:15005-2405
Practice Address - Country:US
Practice Address - Phone:540-226-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACNS000298364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health