Provider Demographics
NPI:1770835423
Name:KESSLER, KIMBERLY (LPN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14464 TOWNSHIP ROAD 57
Mailing Address - Street 2:
Mailing Address - City:RAWSON
Mailing Address - State:OH
Mailing Address - Zip Code:45881-9631
Mailing Address - Country:US
Mailing Address - Phone:419-722-1208
Mailing Address - Fax:
Practice Address - Street 1:14464 TOWNSHIP ROAD 57
Practice Address - Street 2:
Practice Address - City:RAWSON
Practice Address - State:OH
Practice Address - Zip Code:45881-9631
Practice Address - Country:US
Practice Address - Phone:419-722-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH118825164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse