Provider Demographics
NPI:1053411330
Name:HANDEL, KIMBERLY ANNE (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:HANDEL
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:DION
Other - Last Name:HANDEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:1171 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-6310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1850 E PARK AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6706
Practice Address - Country:US
Practice Address - Phone:814-863-8492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP-003351 -C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health