MEDICARE: MRS. KIMBERLY ANN SEXTON M.S., R.D.N.,L.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1326059890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY ANN SEXTON M.S., R.D.N.,L.D

Provider Business Mailing Address
First Line	:	6100 OAK TREE BLVD
Second Line	:
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2544
Country	:	US
Telephone Number	:	216-200-0026
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 OAK TREE BLVD
Second Line	:
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2544
Country	:	US
Telephone Number	:	216-200-0026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	09/12/2023

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