Kimberly Ciccolelli, L.P.N.,A.S.P.T.
Individual provider Active NPI Licensed Practical Nurse · Poland, OH
NPI 1912200775 · NPPES record last updated Dec 15, 2010
Key facts
- NPI
- 1912200775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 140230 (OH)
- Practice address
- 9785 Sena LN
Poland, OH 44514-3266 - Phone
- (330) 651-0930
- NPI assigned
- Dec 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 140230 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 140230 | OH | Yes |
Addresses
Primary practice location
9785 Sena LN
Poland, OH 44514-3266
Mailing address
9785 Sena LN
Poland, OH 44514-3266
Phone (330) 651-0930
Other providers in Poland, OH
- Mylette Le'Chelle Charles
- John Chiaro
- Polixeni Chirgott
- Andrew David Chorey
- Jacqueline Ann Chorey
- Christopher Paul Clautti
- Carol Ann Coler
- Medea Lynn Coler
- Kathryn Ann Conrad
- Copley Counseling Centre Inc
All providers in Poland, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2010. 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.