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NPI Code Detail

MEDICARE: KIMBERELY S PLAJER LPN

MEDICARE: KIMBERELY S PLAJER LPN
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
1164W00000XLicensed Practical NursePN 133478 IVOH

General Provider Information

NPI Number : 1669774105
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERELY S PLAJER LPN
Provider Business Mailing Address
First Line : 3976 SAINT EDMUND AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2326
Country : US
Telephone Number : 330-985-1150
Fax Number :
Provider Business Practice Location Address
First Line : 3976 SAINT EDMUND AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2326
Country : US
Telephone Number : 330-958-1150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2010
Last Update Date : 12/02/2010

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Directions to “ KIMBERELY S PLAJER LPN” Practice Location

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