Healthcare Provider Details

I. General information

NPI: 1760571152
Provider Name (Legal Business Name): KIMBERLY RASPA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WHITEHORSE MERCERVILLE RD # N4
HAMILTON NJ
08619-3834
US

IV. Provider business mailing address

PO BOX 412138 N4
BOSTON MA
02241-2138
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5000
  • Fax:
Mailing address:
  • Phone: 954-939-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN295700L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ15114300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: