Healthcare Provider Details

I. General information

NPI: 1851885255
Provider Name (Legal Business Name): ROBERT KILMER RN, MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 CARROLL ST
AKRON OH
44325
US

IV. Provider business mailing address

340 S BROADWAY ST
AKRON OH
44308-1529
US

V. Phone/Fax

Practice location:
  • Phone: 330-972-5103
  • Fax:
Mailing address:
  • Phone: 330-253-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number023440
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number394001
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: