Provider Demographics
NPI:1740741131
Name:SENKO, KIMBERLY NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:NICOLE
Last Name:SENKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5899 HARRISON AVE
Mailing Address - Street 2:MLC 6011
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248
Mailing Address - Country:US
Mailing Address - Phone:513-803-8200
Mailing Address - Fax:513-803-8173
Practice Address - Street 1:5899 HARRISON AVE
Practice Address - Street 2:MLC 6011
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248
Practice Address - Country:US
Practice Address - Phone:513-803-8200
Practice Address - Fax:513-803-8173
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.147144208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program