Healthcare Provider Details

I. General information

NPI: 1750293916
Provider Name (Legal Business Name): KIMBERLEE COON APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2711
US

IV. Provider business mailing address

6678 BERWICK DR
FRANKLIN OH
45005-3909
US

V. Phone/Fax

Practice location:
  • Phone: 391-208-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberRN386326
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: