Provider Demographics
NPI:1427645746
Name:KINKEL, EDITH
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:KINKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S LEXINGTON SPRINGMILL RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3300
Mailing Address - Country:US
Mailing Address - Phone:216-269-8552
Mailing Address - Fax:
Practice Address - Street 1:640 S LEXINGTON SPRINGMILL RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3300
Practice Address - Country:US
Practice Address - Phone:216-269-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No347C00000XTransportation ServicesPrivate Vehicle
No376J00000XNursing Service Related ProvidersHomemaker