MEDICARE: KIMBERLY A AYERS-BRINGHURST RD

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	133V00000X	Registered Dietitian	DN003176	PA

General Provider Information

NPI Number	:	1912960279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A AYERS-BRINGHURST RD

Provider Business Mailing Address
First Line	:	5445 LANARK RD STE 301
Second Line	:
City	:	CENTER VALLEY
State	:	PA
Zip	:	18034-8694
Country	:	US
Telephone Number	:	484-526-7300
Fax Number	:	833-204-9606

Provider Business Practice Location Address
First Line	:	5425 LANARK RD STE 300
Second Line	:
City	:	CENTER VALLEY
State	:	PA
Zip	:	18034-8697
Country	:	US
Telephone Number	:	484-658-2788
Fax Number	:	484-822-6145

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

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	05/15/2023

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Directions to “ KIMBERLY A AYERS-BRINGHURST RD” Practice Location

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