Provider Demographics
NPI:1841613791
Name:ONDASH, KIMBERLY (CP N)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:ONDASH
Suffix:
Gender:F
Credentials:CP N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2709
Mailing Address - Country:US
Mailing Address - Phone:440-735-3608
Mailing Address - Fax:
Practice Address - Street 1:26110 EMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5788
Practice Address - Country:US
Practice Address - Phone:440-368-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 15154363L00000X
OHAPRN.CNP.15154363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner