Provider Demographics
NPI:1861089450
Name:ROBINSON, KIM BEVERLY (LPN)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:BEVERLY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3864 OLMSBY DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6646
Mailing Address - Country:US
Mailing Address - Phone:234-755-1875
Mailing Address - Fax:
Practice Address - Street 1:4003 STATE ROUTE 44
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9633
Practice Address - Country:US
Practice Address - Phone:330-325-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide