Basic Information
Provider Information
NPI: 1780683607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNOSKI
FirstName: KIMBERLY
MiddleName: LINGREN
NamePrefix: MS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LINGREN
OtherFirstName: KIMBERLY
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: APRN-BC
OtherLastNameType: 1
Mailing Information
Address1: 1906 MARGARET ST
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152091467
CountryCode: US
TelephoneNumber: 4127611190
FaxNumber: 4127610525
Practice Location
Address1: 11279 PERRY HWY STE 450
Address2:  
City: WEXFORD
State: PA
PostalCode: 150909394
CountryCode: US
TelephoneNumber: 4127611190
FaxNumber: 4127610525
Other Information
ProviderEnumerationDate: 07/21/2005
LastUpdateDate: 08/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XTP001937DPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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