MEDICARE: KIMBERLY BOYLE

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
1	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346842515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BOYLE

Provider Business Mailing Address
First Line	:	5360 DESERTGOLD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-3502
Country	:	US
Telephone Number	:	513-628-3962
Fax Number	:

Provider Business Practice Location Address
First Line	:	5360 DESERTGOLD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-3502
Country	:	US
Telephone Number	:	513-628-3962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2020
Last Update Date	:	09/08/2021

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Directions to “ KIMBERLY BOYLE ” Practice Location

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