Individual
MS. KIMBERLY NICOLE ANGELINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4000
Mailing address
1921 FAIRMOUNT AVE # R12, PHILADELPHIA, PA 19130-2036
(610) 360-0306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA060319
PA
363AM0700X
Medical Physician Assistant
Primary
MA060319
PA
Other
Enumeration date
10/24/2018
Last updated
07/18/2025
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