Provider Demographics
NPI:1124460027
Name:HARSHBERGER, KIMBERLY (WHNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:HARSHBERGER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4751 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3707
Mailing Address - Country:US
Mailing Address - Phone:623-934-7006
Mailing Address - Fax:623-937-3014
Practice Address - Street 1:4751 N 15TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-3707
Practice Address - Country:US
Practice Address - Phone:623-934-7006
Practice Address - Fax:623-937-3014
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5104363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology