Provider Demographics
NPI:1659810737
Name:BELL, KIMBERLY ANN (MSN, RN, NP-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:BELL
Suffix:
Gender:F
Credentials:MSN, RN, NP-C
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:SARGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, NP-C
Mailing Address - Street 1:4790 COTTONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45335-1518
Mailing Address - Country:US
Mailing Address - Phone:937-675-2870
Mailing Address - Fax:937-675-2873
Practice Address - Street 1:1157 N MONROE DR STE 220
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1699
Practice Address - Country:US
Practice Address - Phone:937-374-3484
Practice Address - Fax:937-374-7484
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN217101 APRN020535363LF0000X
OHAPRN.CNP.020535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0207911Medicaid
OH0207911Medicaid