Healthcare Provider Details

I. General information

NPI: 1831344795
Provider Name (Legal Business Name): KIMBERLY A BARKELEW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY HUTCHESON LPN

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 N DUCK CREEK RD
NORTH JACKSON OH
44451-9658
US

IV. Provider business mailing address

1695 N DUCK CREEK RD
NORTH JACKSON OH
44451-9658
US

V. Phone/Fax

Practice location:
  • Phone: 330-207-9676
  • Fax:
Mailing address:
  • Phone: 330-207-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number424327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: