Healthcare Provider Details

I. General information

NPI: 1649109133
Provider Name (Legal Business Name): KIMBERLY ANN BRENGARTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 EMERALD PKWY
DUBLIN OH
43017-1008
US

IV. Provider business mailing address

4303 BRIGHT RD
DUBLIN OH
43016-9181
US

V. Phone/Fax

Practice location:
  • Phone: 614-718-6645
  • Fax:
Mailing address:
  • Phone: 614-718-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN274314
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: