Provider Demographics
NPI:1801232509
Name:STIMPERT, KYLE ELISABETH (ACNP)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:ELISABETH
Last Name:STIMPERT
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:SEIDMAN CANCER CENTER, 4TH FLOOR
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-286-3466
Mailing Address - Fax:216-286-5779
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:SEIDMAN CANCER CENTER, 4TH FLOOR
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-286-3466
Practice Address - Fax:216-286-5779
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 323444363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care