Provider Demographics
NPI:1396979068
Name:KIMANI, WINNIE (LPN)
Entity type:Individual
Prefix:MISS
First Name:WINNIE
Middle Name:
Last Name:KIMANI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38365 NORTH LN # G109
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-7415
Mailing Address - Country:US
Mailing Address - Phone:440-521-5461
Mailing Address - Fax:
Practice Address - Street 1:38365 NORTH LN # G109
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-7415
Practice Address - Country:US
Practice Address - Phone:440-521-5461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 131441164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse