Provider Demographics
NPI:1891398376
Name:KIMBERLING, VIRGINIA ARLENE
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ARLENE
Last Name:KIMBERLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 ROCKBROOK CROSSING AVE
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-9806
Mailing Address - Country:US
Mailing Address - Phone:614-975-8771
Mailing Address - Fax:
Practice Address - Street 1:138 ROCKBROOK CROSSING AVE
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-9806
Practice Address - Country:US
Practice Address - Phone:614-975-8771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty