Provider Demographics
NPI:1942570080
Name:KOPFMAN, KIMBERLY M (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:M
Last Name:KOPFMAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:M
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:3300 RIVERSIDE DRIVE, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1738
Mailing Address - Country:US
Mailing Address - Phone:614-459-4200
Mailing Address - Fax:614-459-1589
Practice Address - Street 1:3300 RIVERSIDE DRIVE, SUITE 200
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-1738
Practice Address - Country:US
Practice Address - Phone:614-459-4200
Practice Address - Fax:614-459-1589
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.5538133V00000X
OHRN.399668163W00000X
OHALPP-3267174N00000X
OHCOA.18068-NP363LP0200X
OH10868-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No174N00000XOther Service ProvidersLactation Consultant, Non-RN