1962682526 NPI number — KIMBERLY ROBINSON RN

Table of content: KIMBERLY ROBINSON RN (NPI 1962682526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962682526 NPI number — KIMBERLY ROBINSON RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
KIMBERLY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEMBERTON
Provider Other First Name:
KIMBERLY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962682526
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5768 INDIANOLA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORTHINGTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43085-3780
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-578-3936
Provider Business Mailing Address Fax Number:
514-430-8825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5500 GLENDON CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016-3246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-641-2010
Provider Business Practice Location Address Fax Number:
614-430-8825
Provider Enumeration Date:
11/12/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X , with the licence number:  RN276880 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)