Provider Demographics
NPI:1093833287
Name:HEARST, KIMBERLY LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:HEARST
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 1:7410 HUNTRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4420
Mailing Address - Country:US
Mailing Address - Phone:513-903-9448
Mailing Address - Fax:
Practice Address - Street 1:7410 HUNTRIDGE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4420
Practice Address - Country:US
Practice Address - Phone:513-903-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-353518163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse