Provider Demographics
NPI:1003071523
Name:FREEMAN, KIM S (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:S
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 BANNING RD
Mailing Address - Street 2:#12
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-5571
Mailing Address - Country:US
Mailing Address - Phone:513-741-3745
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL VILLAGE DRIVE ST. ELIZABETH MEDICAL CENTER
Practice Address - Street 2:ST. ELIZABETH MEDICAL CENTER
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-301-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH268816163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse