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General NPI Number Information
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NPI Number | 1730011941
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Entity Type | Individual
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Provider Name | MERCEDES ELLEN KIMM OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 401 E SPRUCE ST
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City | GARDEN CITY
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State | KS
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Zip | 67846-5672
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Country | US
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Telephone | 620-272-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 602 WARRIOR ST UNIT B
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City | GARDEN CITY
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State | KS
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Zip | 67846-0520
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Country | US
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Telephone | 507-210-5871
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-04196
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 138422
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License Number State | IA
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