Individual
KIMBERLY S SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3477
(937) 641-5410
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-5072
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.03816
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200514510
—
IN
05
—
2044291
—
OH
Enumeration date
07/21/2005
Last updated
10/12/2023
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