MEDICARE: KIMBERLY ANN BADER CPRS

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	175T00000X	Peer Specialist	PRS.007480	OH

General Provider Information

NPI Number	:	1760338164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ANN BADER CPRS

Provider Business Mailing Address
First Line	:	1218 JANET AVE NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-1839
Country	:	US
Telephone Number	:	330-858-0858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 JANET AVE NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-1839
Country	:	US
Telephone Number	:	330-858-0858
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ KIMBERLY ANN BADER CPRS” Practice Location

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