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NPI Code Detail

MEDICARE: MRS. KIM ANN AMBERGER-FLEDDERMAN

MEDICARE:  MRS. KIM ANN AMBERGER-FLEDDERMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1316427412
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIM ANN AMBERGER-FLEDDERMAN
Provider Business Mailing Address
First Line : 2920 10TH ST # 1023
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-6602
Country : US
Telephone Number : 800-745-7686
Fax Number : 812-378-2849
Provider Business Practice Location Address
First Line : 2920 10TH ST
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-6602
Country : US
Telephone Number : 800-745-7686
Fax Number : 812-378-2849
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2018
Last Update Date : 08/17/2018

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Directions to “ MRS. KIM ANN AMBERGER-FLEDDERMAN ” Practice Location

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