Healthcare Provider Details

I. General information

NPI: 1629407531
Provider Name (Legal Business Name): KIMBERLY LEVERING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2013
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 RED BANK RD SUITE 210
CINCINNATI OH
45227-2176
US

IV. Provider business mailing address

4440 RED BANK RD SUITE 210
CINCINNATI OH
45227-2176
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-0313
  • Fax: 513-272-0316
Mailing address:
  • Phone: 513-272-0313
  • Fax: 513-272-0316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number14984
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: