Basic Information
| Provider Information | |||||||||
| NPI: | 1003801168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEHANA | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | EVANS | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN, CRNP, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 97 | ||||||||
| Address2: | |||||||||
| City: | PERRYOPOLIS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154730097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249292260 | ||||||||
| FaxNumber: | 7249293880 | ||||||||
| Practice Location | |||||||||
| Address1: | 1645 ROSTRAVER RD | ||||||||
| Address2: | |||||||||
| City: | BELLE VERNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150129655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249292260 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2005 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | TP006353B | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.