Provider Demographics
NPI:1235620956
Name:SADLER, KIMBERLY LYNN (APRN CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LYNN
Last Name:SADLER
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-9478
Mailing Address - Country:US
Mailing Address - Phone:419-203-2414
Mailing Address - Fax:
Practice Address - Street 1:1050 EAST GREENVILLE RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885
Practice Address - Country:US
Practice Address - Phone:419-394-3331
Practice Address - Fax:419-394-3330
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily