MEDICARE: RACHEL MARIE KIMMEY CNP

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	363L00000X	Nurse Practitioner	APRN.CNP.0041103	OH

General Provider Information

NPI Number	:	1841165172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MARIE KIMMEY CNP

Provider Business Mailing Address
First Line	:	770 W HIGH ST STE 210
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-5902
Country	:	US
Telephone Number	:	419-226-9610
Fax Number	:	419-226-9602

Provider Business Practice Location Address
First Line	:	770 W HIGH ST STE 210
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-5902
Country	:	US
Telephone Number	:	419-226-9016
Fax Number	:	419-226-9602

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

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	06/10/2026

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