Provider Demographics
NPI:1437696572
Name:HEUSER, KIMBERLY A (CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:HEUSER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:NOVENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-533-6553
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:3525 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 5300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3937
Practice Address - Country:US
Practice Address - Phone:614-566-3500
Practice Address - Fax:614-533-0150
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020453363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology