Provider Demographics
NPI:1477908713
Name:MEYERS, KIMBERLY HOPE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:HOPE
Last Name:MEYERS
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 1:2144 W HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9524
Mailing Address - Country:US
Mailing Address - Phone:513-479-0217
Mailing Address - Fax:
Practice Address - Street 1:2144 W HORIZON DR
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-9524
Practice Address - Country:US
Practice Address - Phone:513-479-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-24
Last Update Date:2016-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2180634Medicaid