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General NPI Number Information
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NPI Number | 1942972625
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Entity Type | Individual
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Provider Name | KIMBERLY RAE SLIDER CRPN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2645 N 3RD ST FL 2
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City | HARRISBURG
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State | PA
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Zip | 17110-2001
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Country | US
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Telephone | 717-782-4650
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Fax | 717-782-4665
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Provider Business Mailing Address
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Address Line | 111 CHAMBERS HILL DR STE 200
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-7304
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Country | US
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Telephone | 717-709-7922
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Fax | 717-263-2055
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP022644
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP022644
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | SP022644
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License Number State | PA
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