Provider Demographics
NPI:1275836199
Name:KIEHL, UNKNOWN (RN)
Entity Type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:KIEHL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 GURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-2556
Mailing Address - Country:US
Mailing Address - Phone:330-865-4617
Mailing Address - Fax:
Practice Address - Street 1:1425 GURLEY AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2556
Practice Address - Country:US
Practice Address - Phone:330-865-4617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN358711163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse