Provider Demographics
NPI:1508079401
Name:KEMATS, KIMBERLY ANN
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:KEMATS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6971 ADAMS ROAD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:OH
Mailing Address - Zip Code:44455-9707
Mailing Address - Country:US
Mailing Address - Phone:330-426-1853
Mailing Address - Fax:330-420-9194
Practice Address - Street 1:6971 ADAMS ROAD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:OH
Practice Address - Zip Code:44455-9707
Practice Address - Country:US
Practice Address - Phone:330-426-1853
Practice Address - Fax:330-420-9194
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2351557251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health