Healthcare Provider Details

I. General information

NPI: 1396069860
Provider Name (Legal Business Name): SANDRA J KINDNESS C-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 RAY NORRISH DR
CINCINNATI OH
45246-1520
US

IV. Provider business mailing address

440 RAY NORRISH DR
CINCINNATI OH
45246-1520
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-5548
  • Fax: 513-791-5549
Mailing address:
  • Phone: 513-791-5548
  • Fax: 513-791-5549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11240-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2296236
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: