MEDICARE: KIMBERLY GILES SOLE PROVIDER

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1326759085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY GILES SOLE PROVIDER

Provider Business Mailing Address
First Line	:	795 GIBBARD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3734
Country	:	US
Telephone Number	:	161-432-6969
Fax Number	:

Provider Business Practice Location Address
First Line	:	795 GIBBARD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3734
Country	:	US
Telephone Number	:	614-326-9695
Fax Number	:

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

Provider Enumeration Date	:	12/13/2022
Last Update Date	:	12/13/2022

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Directions to “ KIMBERLY GILES SOLE PROVIDER” Practice Location

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