Healthcare Provider Details

I. General information

NPI: 1457269052
Provider Name (Legal Business Name): KIMBERLY LAHOVSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S HOME AVE
TOPTON PA
19562-1317
US

IV. Provider business mailing address

2048 PEPPERMINT DR
MACUNGIE PA
18062-8921
US

V. Phone/Fax

Practice location:
  • Phone: 610-682-1400
  • Fax:
Mailing address:
  • Phone: 570-242-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP037070
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: