MEDICARE: KIMBERLY DRUM DNP

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	26NJ01056400	NJ

General Provider Information

NPI Number	:	1699381681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DRUM DNP

Provider Business Mailing Address
First Line	:	550 OAK ST
Second Line	:
City	:	PORT MONMOUTH
State	:	NJ
Zip	:	07758-1282
Country	:	US
Telephone Number	:	732-778-6714
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 NJ-88
Second Line	:
City	:	BRICK TOWNSHIP
State	:	NJ
Zip	:	08724
Country	:	US
Telephone Number	:	732-458-1903
Fax Number	:

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

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	01/18/2023

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