Individual
KIMBERLY BARDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-0001
(570) 214-4745
Mailing address
208 LOWER MULBERRY ST, DANVILLE, PA 17821-1521
(570) 271-8067
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
SP030028
PA
363L00000X
Nurse Practitioner
Primary
SP030028
PA
Other
Enumeration date
07/09/2024
Last updated
10/31/2024
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