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General NPI Number Information
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NPI Number | 1104192699
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Entity Type | Individual
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Provider Name | KIMBERLY ANN TOBIN CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 611 GRAVEL PIKE
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-1600
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Country | US
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Telephone | 610-489-4151
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Fax |
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Provider Business Mailing Address
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Address Line | 230 N 7TH AVE
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City | ROYERSFORD
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State | PA
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Zip | 19468-2114
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Country | US
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Telephone | 610-513-8090
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP011916
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License Number State | PA
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