Provider Demographics
NPI:1396399077
Name:BABICH-SPECK, KIMBERLY ANNMARIE (APRN CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNMARIE
Last Name:BABICH-SPECK
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 1:19443 SPINNAKER CIR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7110
Mailing Address - Country:US
Mailing Address - Phone:440-708-8434
Mailing Address - Fax:
Practice Address - Street 1:5526 DETROIT RD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1442
Practice Address - Country:US
Practice Address - Phone:440-961-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024670363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily