Provider Demographics
NPI:1346340064
Name:BARILLA, KIMBERLY A (CRNP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:BARILLA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:BARILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:428 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-1818
Mailing Address - Country:US
Mailing Address - Phone:610-900-4234
Mailing Address - Fax:570-392-6143
Practice Address - Street 1:428 S 7TH ST
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-1818
Practice Address - Country:US
Practice Address - Phone:610-900-4234
Practice Address - Fax:570-392-6143
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP002038D363LP0200X
PASP012242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA522325498OtherTAX ID