Kimberly Lerae Blair, STNA
Individual provider Active NPI Nurse's Aide · Circleville, OH
NPI 1275204232 · NPPES record last updated Sep 21, 2021
Key facts
- NPI
- 1275204232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 321737930905 (OH)
- Practice address
- 110 Highland Ave
Circleville, OH 43113-1208 - Phone
- (740) 477-1745
- NPI assigned
- Sep 21, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 321737930905 | OH | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 321737930905 | OH | Yes |
Addresses
Primary practice location
110 Highland Ave
Circleville, OH 43113-1208
Mailing address
110 Highland Ave
Circleville, OH 43113-1208
Phone (740) 477-1745
Other names
- Kimberly Lerae Tackett
Other providers in Circleville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.