Healthcare Provider Details

I. General information

NPI: 1962127241
Provider Name (Legal Business Name): KIMBERLY ANGEL PAMELA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/10/2022
Certification Date: 10/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6285 CHEVIOT RD APT 4
CINCINNATI OH
45247-6160
US

IV. Provider business mailing address

6285 CHEVIOT RD APT 4
CINCINNATI OH
45247-6160
US

V. Phone/Fax

Practice location:
  • Phone: 513-253-6942
  • Fax:
Mailing address:
  • Phone: 513-253-6942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: