Healthcare Provider Details

I. General information

NPI: 1275783128
Provider Name (Legal Business Name): KIMBERLY BAGGIO CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 E MAIN ST
MORGANTOWN PA
19543-8917
US

IV. Provider business mailing address

945 HILL AVE STE 300
WYOMISSING PA
19610-3026
US

V. Phone/Fax

Practice location:
  • Phone: 610-285-3820
  • Fax:
Mailing address:
  • Phone: 610-285-8320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP017237
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382013
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: