Provider Demographics
NPI:1356765200
Name:STURZENBECKER, KIMBERLY JANE (FNP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:JANE
Last Name:STURZENBECKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:JANE
Other - Last Name:KOLASSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9935 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-9777
Mailing Address - Country:US
Mailing Address - Phone:716-680-2890
Mailing Address - Fax:
Practice Address - Street 1:26 CASS ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NY
Practice Address - Zip Code:14787-1113
Practice Address - Country:US
Practice Address - Phone:716-680-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily