Healthcare Provider Details

I. General information

NPI: 1447005624
Provider Name (Legal Business Name): ABBIGAIL KLINGENSMITH BSN, RN, CPN, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2024
Last Update Date: 04/20/2024
Certification Date: 04/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3869 HAMPSHIRE AVE
POWELL OH
43065-7762
US

IV. Provider business mailing address

3869 HAMPSHIRE AVE
POWELL OH
43065-7762
US

V. Phone/Fax

Practice location:
  • Phone: 614-581-0012
  • Fax:
Mailing address:
  • Phone: 614-581-0012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN.415769
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: