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NPI Code Detail

MEDICARE: KIMBERLY ABBATICOLA MSN, APRN, PMHNP-BC

MEDICARE: KIMBERLY ABBATICOLA MSN, APRN, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN03094RI

General Provider Information

NPI Number : 1467045278
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ABBATICOLA MSN, APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 58 GRANDE BROOK CIR APT 1331
Second Line :
City : SOUTH KINGSTOWN
State : RI
Zip : 02879-8220
Country : US
Telephone Number : 401-594-5056
Fax Number :
Provider Business Practice Location Address
First Line : 27 RANDOLPH RD
Second Line :
City : HOWELL
State : NJ
Zip : 07731-8611
Country : US
Telephone Number : 866-708-1240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2021
Last Update Date : 11/21/2024

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