Provider Demographics
NPI:1326759085
Name:GILES, KIMBERLY (SOLE PROVIDER)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:GILES
Suffix:
Gender:F
Credentials:SOLE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 GIBBARD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3734
Mailing Address - Country:US
Mailing Address - Phone:161-432-6969
Mailing Address - Fax:
Practice Address - Street 1:795 GIBBARD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3734
Practice Address - Country:US
Practice Address - Phone:614-326-9695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide