Provider Demographics
NPI:1164395869
Name:FLANDERS, KIMBERLY ANN (MA)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:FLANDERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MARIEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9206
Mailing Address - Country:US
Mailing Address - Phone:419-934-3693
Mailing Address - Fax:
Practice Address - Street 1:19 MARIEMONT AVE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9206
Practice Address - Country:US
Practice Address - Phone:419-934-3693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251C00000X, 3747A0650X, 171M00000X, 376J00000X, 372600000X, 172A00000X, 347C00000X, 3747P1801X, 251E00000X, 372500000X, 253Z00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion
No172A00000XOther Service ProvidersDriver
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health
No372500000XNursing Service Related ProvidersChore Provider
No251B00000XAgenciesCase Management