MEDICARE: KIMBERLY DENISE HUDSON

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1386588846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DENISE HUDSON

Provider Business Mailing Address
First Line	:	3433 BLUE ROCK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-5103
Country	:	US
Telephone Number	:	513-480-9200
Fax Number	:	513-480-9200

Provider Business Practice Location Address
First Line	:	1841 FAIRMOUNT AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45214-1224
Country	:	US
Telephone Number	:	513-480-9200
Fax Number	:	513-480-9200

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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