Provider Demographics
NPI:1396091963
Name:HARRINGTON, KIMBERLY RENA
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:RENA
Last Name:HARRINGTON
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 1:225 KNOLLRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8811
Mailing Address - Country:US
Mailing Address - Phone:513-344-9479
Mailing Address - Fax:
Practice Address - Street 1:225 KNOLLRIDGE CT
Practice Address - Street 2:304
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3554
Practice Address - Country:US
Practice Address - Phone:513-344-9479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2046592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse