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NPI Code Detail

MEDICARE: MRS. KIMBERLY ANN MEAD CPNP

MEDICARE: MRS. KIMBERLY ANN MEAD CPNP
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
1363LP0200XPediatric Nurse PractitionerRN.314602OH

General Provider Information

NPI Number : 1548394125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY ANN MEAD CPNP
Provider Business Mailing Address
First Line : 4224 OAKWOOD AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2526
Country : US
Telephone Number : 513-321-2198
Fax Number :
Provider Business Practice Location Address
First Line : 752 WAYCROSS RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-3184
Country : US
Telephone Number : 513-825-9595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 07/08/2007

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