Kimberly Bernice Nelson, MS, MBA, RN

Primary specialty

Continuing Education/Staff Development Registered NurseTaxonomy code 163WC1600X

License

RN601348 Issued in PA

Practice address

1930 S Broad St
Philadelphia, PA 19145-2328

Phone

(215) 339-4563

NPI assigned

Feb 27, 2012

Last updated

Feb 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Master of Science, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1871867598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 MOUNT VERNON ST",
            "address_2": "#2F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303449",
            "telephone_number": "267-639-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452328",
            "telephone_number": "215-339-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KIMBERLY",
        "middle_name": "BERNICE",
        "name_prefix": "Ms.",
        "credential": "MS, MBA, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R157787",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "PA",
            "license": "RN601348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernest James Nelson Jr., MD
• Grace Isabella Nelson, CPNP-AC
• Gregory Alan Nelson, M.D.
• Joanna E Nelson, MD
• Joshua Isaac Nelson, MD
• Kortney Nelson
• Latifah Nelson, CRNP
• Matthew A. Nelson, DMD
• Maya Nelson, LCSW
• Megan Nicole Nelson

• Continuing Education/Staff Development Registered Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Continuing Education/Staff Development Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.