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General NPI Number Information
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NPI Number | 1760101182
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Entity Type | Individual
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Provider Name | KIMBERLY B BERENBAUM CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1101 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-3612
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Country | US
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Telephone | 215-955-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 CENTENNIAL RD
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City | PENN VALLEY
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State | PA
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Zip | 19072-1206
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Country | US
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Telephone |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP022248
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License Number State | PA
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