Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | TP006353B | PA |
NPI | 1003801168 |
---|---|
Provider Name | Ms. Kimberly Evans Behana |
First Address | Perryopolis, PA 15473-0097 |
Second Address | Belle Vernon, PA 15012-9655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 06/10/2020 |