Provider Demographics
NPI:1285366930
Name:SIMS, KESCHA (STNA)
Entity type:Individual
Prefix:
First Name:KESCHA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3909
Mailing Address - Country:US
Mailing Address - Phone:513-888-6484
Mailing Address - Fax:
Practice Address - Street 1:3923 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3909
Practice Address - Country:US
Practice Address - Phone:513-888-6484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty