Provider Demographics
NPI:1851434682
Name:HUSEMAN, KIMBERLEY MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:MARIE
Last Name:HUSEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KIMBERLEY
Other - Middle Name:MARIE
Other - Last Name:SPALDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1536 STORY AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1738
Mailing Address - Country:US
Mailing Address - Phone:502-589-1500
Mailing Address - Fax:502-589-1556
Practice Address - Street 1:10731 HIGHWAY 44 E
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7696
Practice Address - Country:US
Practice Address - Phone:502-538-0500
Practice Address - Fax:502-589-1556
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1613 DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist