Provider Demographics
NPI:1912960279
Name:AYERS-BRINGHURST, KIMBERLY A (RD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:AYERS-BRINGHURST
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:5445 LANARK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8694
Mailing Address - Country:US
Mailing Address - Phone:484-526-7300
Mailing Address - Fax:833-204-9606
Practice Address - Street 1:5425 LANARK RD STE 300
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8697
Practice Address - Country:US
Practice Address - Phone:484-658-2788
Practice Address - Fax:484-822-6145
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003176133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA071469R8GMedicare ID - Type Unspecified