Provider Demographics
NPI:1336405661
Name:ROBINSON, KIMBERLEY ALYCE (RN MT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:ALYCE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RN MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 BRYN WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT WOLF
Mailing Address - State:PA
Mailing Address - Zip Code:17347-9208
Mailing Address - Country:US
Mailing Address - Phone:717-951-4899
Mailing Address - Fax:
Practice Address - Street 1:66 BRYN WAY
Practice Address - Street 2:
Practice Address - City:MOUNT WOLF
Practice Address - State:PA
Practice Address - Zip Code:17347
Practice Address - Country:US
Practice Address - Phone:717-951-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000407171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor