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Individual

KIMBERLY A WESTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
640 S STATE ST, DOVER, DE 19901-3530
(302) 674-4700
(302) 744-6407
Mailing address
14119 SEA CAPTAIN RD, OCEAN CITY, MD 21842-5637
(215) 917-6678

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN354673L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024183064
VA
367500000X
Certified Registered Nurse Anesthetist
053594
PA
367500000X
Certified Registered Nurse Anesthetist
L6-0A00820
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018704150005
PA
01
11803087
CAQH
PA
01
1419911
KHP CENTRAL
PA
01
1542843
GATEWAY
PA
01
2106205000
INDEP. BLUE CROSS
PA
01
50003224
CAPITAL ADVANTAGE
PA
01
77529
GEISINGER
PA
01
9401436
AETNA
PA
Enumeration date
10/03/2005
Last updated
11/02/2023
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