Provider Demographics
NPI:1699800425
Name:STRUNK, KIMBERLEY SUE (MS, OTR)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:SUE
Last Name:STRUNK
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:DEHAAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BOULEVARD
Mailing Address - Street 2:SUITE 3070
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:765-450-6664
Practice Address - Street 1:625 N. UNION STREET
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-2907
Practice Address - Country:US
Practice Address - Phone:765-252-0530
Practice Address - Fax:765-450-6664
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002242A225X00000X, 225XP0200X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200533250Medicaid
IN000000375491OtherANTHEM
IN200533240Medicaid