Provider Demographics
NPI:1366926156
Name:KEKEL, KIM FLORENCE (RN)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:FLORENCE
Last Name:KEKEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3743 COMPTON CT
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-5450
Mailing Address - Country:US
Mailing Address - Phone:330-780-6485
Mailing Address - Fax:
Practice Address - Street 1:4405 STOW RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1844
Practice Address - Country:US
Practice Address - Phone:330-689-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.251143163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool