Provider Demographics
NPI:1932365301
Name:FLOWERS, KIMBERLY KAY (NP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4299
Mailing Address - Country:US
Mailing Address - Phone:419-214-4214
Mailing Address - Fax:419-479-5593
Practice Address - Street 1:3355 MEIJER DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3102
Practice Address - Country:US
Practice Address - Phone:419-725-6850
Practice Address - Fax:419-725-6853
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-10090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH29140676Medicaid
OHH230210Medicare PIN
OH29140676Medicaid