Healthcare Provider Details

I. General information

NPI: 1912838590
Provider Name (Legal Business Name): STEPHANIE KINGTON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7488 BOLD VENTURE CT
LEWIS CENTER OH
43035-8154
US

IV. Provider business mailing address

7488 BOLD VENTURE CT
LEWIS CENTER OH
43035-8154
US

V. Phone/Fax

Practice location:
  • Phone: 614-560-1908
  • Fax:
Mailing address:
  • Phone: 614-560-1908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: