Healthcare Provider Details

I. General information

NPI: 1912036260
Provider Name (Legal Business Name): KATHLEEN ANN KOBBERGER R.N.APN.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 UNION PL
SUMMIT NJ
07901-3656
US

IV. Provider business mailing address

21 MEADOWBROOK RD
SHORT HILLS NJ
07078-3335
US

V. Phone/Fax

Practice location:
  • Phone: 973-218-1776
  • Fax: 908-522-1995
Mailing address:
  • Phone: 973-379-2364
  • Fax: 973-379-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR02353700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number26NC02353700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: