Provider Demographics
NPI:1427361948
Name:BONAPFEL, KIMBERLEE ANN (LPN)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:ANN
Last Name:BONAPFEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KIMBERLEE
Other - Middle Name:ANN
Other - Last Name:KALB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:101 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:IN
Mailing Address - Zip Code:47060-1035
Mailing Address - Country:US
Mailing Address - Phone:513-256-1947
Mailing Address - Fax:
Practice Address - Street 1:101 MILL ST
Practice Address - Street 2:
Practice Address - City:WEST HARRISON
Practice Address - State:IN
Practice Address - Zip Code:47060-1035
Practice Address - Country:US
Practice Address - Phone:513-256-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.104530 M IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse