Provider Demographics
NPI:1073034864
Name:HOHMAN, KIMBERLY SUE (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SUE
Last Name:HOHMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 SOUTH COUNTY ROAD 47
Mailing Address - Street 2:
Mailing Address - City:NEW RIEGEL
Mailing Address - State:OH
Mailing Address - Zip Code:44853
Mailing Address - Country:US
Mailing Address - Phone:419-455-3202
Mailing Address - Fax:
Practice Address - Street 1:4651 SOUTH COUNTY ROAD 47
Practice Address - Street 2:
Practice Address - City:NEW RIEGEL
Practice Address - State:OH
Practice Address - Zip Code:44853
Practice Address - Country:US
Practice Address - Phone:419-455-3202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN249628163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse