Healthcare Provider Details

I. General information

NPI: 1558646489
Provider Name (Legal Business Name): KIMBERLY ELSER ADVANCED PRACTICE NURSING SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13157 NW 11TH PL
SUNRISE FL
33323-2957
US

IV. Provider business mailing address

13157 NW 11TH PL
SUNRISE FL
33323-2957
US

V. Phone/Fax

Practice location:
  • Phone: 754-200-6074
  • Fax:
Mailing address:
  • Phone: 754-200-6074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN 9294970
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN 9294970
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN 9294970
License Number StateFL

VIII. Authorized Official

Name: DR. KIMBERLY M. ELSER
Title or Position: NURSE PRACTITIONER
Credential: DNP, ARNP, CNM, FNP-
Phone: 754-200-6074