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General NPI Number Information
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NPI Number | 1902462054
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Entity Type | Individual
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Provider Name | KIMBERLY CARLENE LETSON APRN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 3562 RIDGE PARK DR STE D1
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City | FAIRLAWN
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State | OH
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Zip | 44333-9294
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Country | US
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Telephone | 330-664-1670
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Fax |
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Provider Business Mailing Address
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Address Line | 4387 LEEWOOD RD
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City | STOW
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State | OH
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Zip | 44224-2520
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Country | US
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Telephone | 330-807-5421
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN.313361
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | APRN.CNP.024571
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.024571
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License Number State | OH
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