Healthcare Provider Details

I. General information

NPI: 1659609352
Provider Name (Legal Business Name): KIMBERLY MICHELLE REED MS, RNC-NIC, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ
DAYTON OH
45404-1873
US

IV. Provider business mailing address

896 E SOCIAL ROW RD
CENTERVILLE OH
45458-4708
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number15510
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number95001750
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAPRN.CNP.020210
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number804796
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-330290
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: