Provider Demographics
NPI:1730960642
Name:ADAMS, KIMBERLY KENYTA
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:KENYTA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18231 EUCLID AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1042
Mailing Address - Country:US
Mailing Address - Phone:216-924-8400
Mailing Address - Fax:
Practice Address - Street 1:18231 EUCLID AVE APT 203
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1042
Practice Address - Country:US
Practice Address - Phone:216-924-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle