Provider Demographics
NPI:1356149405
Name:WELLMAN, KIMBERLY L
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:WELLMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 CLAIRE CT
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-8811
Mailing Address - Country:US
Mailing Address - Phone:740-601-6444
Mailing Address - Fax:
Practice Address - Street 1:103 CAMBER DR
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-8996
Practice Address - Country:US
Practice Address - Phone:740-601-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty