Provider Demographics
NPI:1205227238
Name:FEENY, KIM RENEE (RN)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:RENEE
Last Name:FEENY
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 1:501 S PLUM ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-3346
Mailing Address - Country:US
Mailing Address - Phone:937-332-3926
Mailing Address - Fax:937-335-9585
Practice Address - Street 1:501 S PLUM ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-3346
Practice Address - Country:US
Practice Address - Phone:937-332-3926
Practice Address - Fax:937-335-9585
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH233384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse