Russell, Kimberly Sue

Russell, Kimberly Sue is an sole proprietor health care provider with primary practice located at 81 Rhoads Center Dr , Centerville OH 45458-3859. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Russell, Kimberly Sue can be contacted via phone (937) 435-1161.

Contact Information

Primary practice address
81 Rhoads Center Dr Centerville OH 45458-3859
Phone: (937) 435-1161
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN109782 Ohio
Nursing Service Providers / Licensed Practical Nurse 164W00000X 109782 Ohio

Profile Details

NPI number 1780828343
LBN Legal business name Russell, Kimberly Sue
Credentials NURSE/LPN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2009
Last updated Apr 27th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780828343 NPPES
Ohio MEDICAID 2586867

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