Doctor Name: | KIMBERLY ANN KETCHUM |
NPI Number: | 1598988156 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | RN259417 |
Business Practice Address: | 7502 Tamkrist Trl Conneaut, OH - 440303193 |
Business Phone Number: | 4402242863 |
Business Fax Number: | |
Mailing Address: | 7502 Tamkrist Trl, CONNEAUT |
State: | OH |
Postal Code: | 440303193 |
Phone Number: | 4402242863 |
Fax Number: | |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 04/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | RN259417 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |