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General NPI Number Information
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NPI Number | 1942833165
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Entity Type | Individual
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Provider Name | KIMBERLY BYSHEIM CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 28105 THREE NOTCH RD # 1C
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City | MECHANICSVILLE
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State | MD
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Zip | 20659-3235
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Country | US
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Telephone | 301-290-1510
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Fax | 301-290-1574
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Provider Business Mailing Address
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Address Line | 1401 HOLLY WOODS DR
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City | LUSBY
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State | MD
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Zip | 20657-4144
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Country | US
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Telephone | 410-474-5251
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Fax | 301-290-1510
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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 | R206634
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License Number State | MD
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