MEDICARE: KIMBERLY A HERLIHY RAND NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ00344300	NJ

General Provider Information

NPI Number	:	1093092488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A HERLIHY RAND NP

Provider Business Mailing Address
First Line	:	3350 HIGHWAY 138 STE 122
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-9694
Country	:	US
Telephone Number	:	732-280-1200
Fax Number	:	732-280-1207

Provider Business Practice Location Address
First Line	:	3350 HIGHWAY 138 STE 122
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-9694
Country	:	US
Telephone Number	:	732-280-1200
Fax Number	:	732-280-1207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	07/21/2022

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