Provider Demographics
NPI:1700205820
Name:BYRNE, KIMBERLEY ANN SHARON (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY ANN
Middle Name:SHARON
Last Name:BYRNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5976 FLOWERING WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-6365
Mailing Address - Country:US
Mailing Address - Phone:740-624-7155
Mailing Address - Fax:330-952-1131
Practice Address - Street 1:5976 FLOWERING WOODS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-6365
Practice Address - Country:US
Practice Address - Phone:740-624-7155
Practice Address - Fax:330-952-1131
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300003163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse