Provider Demographics
NPI:1649872524
Name:REED, KIMBERLEY DARLENE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:DARLENE
Last Name:REED
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:KIMBERLEY
Other - Middle Name:DARLENE
Other - Last Name:ZAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8496 GRENWAY DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6030
Mailing Address - Country:US
Mailing Address - Phone:440-862-7537
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH353048163W00000X
OHTBD367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse