MEDICARE: KIMBERLY BRANTLEY

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	253Z00000X	In Home Supportive Care Agency		OH

General Provider Information

NPI Number	:	1942162714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BRANTLEY

Provider Business Mailing Address
First Line	:	432 CROSS ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44311-1217
Country	:	US
Telephone Number	:	330-203-7682
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 CROSS ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44311-1217
Country	:	US
Telephone Number	:	330-203-7682
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ KIMBERLY BRANTLEY ” Practice Location

Language	Start Address	Practice Location

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