Healthcare Provider Details

I. General information

NPI: 1982943452
Provider Name (Legal Business Name): KIMBERLY NICOLE STEINBERG CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY NICOLE CROUSE CRNP

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 MERIDIAN MARK RD SUITE 130
ATLANTA GA
30342
US

IV. Provider business mailing address

5455 MERIDIAN MARK RD SUITE 130
ATLANTA GA
30342
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-2033
  • Fax: 404-252-1901
Mailing address:
  • Phone: 404-255-2033
  • Fax: 404-252-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR196074
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN245855
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: