Provider Demographics
NPI:1285814046
Name:BEYER, KIMBERLY ANNE (DNP, CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:BEYER
Suffix:
Gender:F
Credentials:DNP, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MERZ BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2895
Mailing Address - Country:US
Mailing Address - Phone:330-864-9000
Mailing Address - Fax:330-864-9004
Practice Address - Street 1:55 MERZ BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2895
Practice Address - Country:US
Practice Address - Phone:330-864-9000
Practice Address - Fax:330-864-9004
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGRNP25661Medicare PIN