Individual
MRS. KIMBERLY M WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6298
(570) 271-5841
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
RN278832L
PA
363L00000X
Nurse Practitioner
Primary
TP006808G
PA
364SW0102X
Women's Health Clinical Nurse Specialist
TP006808G
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1535671
BLUE SHIELD PROVIDER NO.
PA
01
—
50021621
BLUE CROSS PROVIDER NO.
PA
Enumeration date
11/13/2006
Last updated
02/14/2022
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