Provider Demographics
NPI:1275783128
Name:BAGGIO, KIMBERLY (CPNP-PC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:BAGGIO
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 DOWLIN FORGE RD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1550
Mailing Address - Country:US
Mailing Address - Phone:610-458-0500
Mailing Address - Fax:610-458-0505
Practice Address - Street 1:161 DOWLIN FORGE RD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1550
Practice Address - Country:US
Practice Address - Phone:610-458-0500
Practice Address - Fax:610-458-0505
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382013363LP0200X
PASP017237363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics