Individual
KIMBERLY SHERROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1809 NORTHRIDGE RD, COLUMBUS, OH 43224-2859
(614) 390-5792
Mailing address
1809 NORTHRIDGE RD, COLUMBUS, OH 43224-2859
(614) 390-5792
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615030
—
OH
Enumeration date
06/15/2022
Last updated
02/26/2023
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