Individual
KIMBERLY S DILTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
3130 N COUNTY ROAD 25A, STE 103, TROY, OH 45373-1337
(937) 773-0428
(937) 773-0439
Mailing address
3130 N COUNTY ROAD 25A, STE 103, TROY, OH 45373-1337
(937) 773-0428
(937) 773-0439
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
NS04904
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2494877
—
OH
01
—
311176809028
CARESOURCE
OH
Enumeration date
03/09/2007
Last updated
11/18/2013
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