Provider Demographics
NPI:1487240065
Name:LEARN, KIMBERLY JO (APRN)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JO
Last Name:LEARN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:3897 LANTERMAN RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-1317
Mailing Address - Country:US
Mailing Address - Phone:330-651-0268
Mailing Address - Fax:330-792-7146
Practice Address - Street 1:3897 LANTERMAN RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1317
Practice Address - Country:US
Practice Address - Phone:133-065-1026
Practice Address - Fax:330-792-7146
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine