Provider Demographics
NPI:1790392306
Name:KIMES, EMILY (CNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KIMES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:FAETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:701 WHITE POND DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1155
Mailing Address - Country:US
Mailing Address - Phone:330-926-3322
Mailing Address - Fax:330-926-3342
Practice Address - Street 1:701 WHITE POND DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1155
Practice Address - Country:US
Practice Address - Phone:330-926-3322
Practice Address - Fax:330-926-3342
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily