Healthcare Provider Details

I. General information

NPI: 1609574524
Provider Name (Legal Business Name): KIMBERLY ANN KRISTOPHEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 WILMINGTON RD STE 3
NEW CASTLE PA
16105-1959
US

IV. Provider business mailing address

532 CUNNINGHAM LN
NEW CASTLE PA
16105-5816
US

V. Phone/Fax

Practice location:
  • Phone: 724-965-8355
  • Fax: 877-456-7299
Mailing address:
  • Phone: 412-999-4336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN509735L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: