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General NPI Number Information
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NPI Number | 1770834384
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Entity Type | Individual
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Provider Name | KIMBERLY ANNE IRVINE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2012
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 710 ROUTE 28
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City | HARWICH PORT
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State | MA
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Zip | 02646-1931
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Country | US
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Telephone | 508-432-1400
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Fax | 508-487-6298
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Provider Business Mailing Address
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Address Line | PO BOX 598
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City | HARWICH PORT
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State | MA
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Zip | 02646-0598
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Country | US
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Telephone | 508-432-1400
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Fax | 508-487-6298
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2282034
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License Number State | MA
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