MS. KIMBERLY JEAN BUNDRIDGE CNP NPI 1073993317

NPI Information

NPI: 1073993317
Provider Name: MS. KIMBERLY JEAN BUNDRIDGE, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
3500 KOLBE RD
PALLIATIVE CARE DEPT
LORAIN, OH
ZIP 44053
Phone: (440) 934-1458
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MS. Kimberly Jean Bundridge, CNP is a family nurse practitioner in Lorain, OH with 9 years of experience. MS. Kimberly Jean Bundridge, CNP NPI is 1073993317. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3500 KOLBE RD
PALLIATIVE CARE DEPT
LORAIN, OH
ZIP 44053-632
Phone: (440) 934-1458
Fax: (440) 960-4922

The NPI 1073993317 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2015 and was last updated on 9/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	COA .17589-NP	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	9288887	MEDICARE PIN	OHIO
2	H384641	MEDICARE PIN	OHIO
3	0207207	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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