Basic Information
| Provider Information | |||||||||
| NPI: | 1851885255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KILMER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RN, MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 S BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443081529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302533100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 209 CARROLL ST | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309725103 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2018 | ||||||||
| LastUpdateDate: | 09/06/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 023440 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 163WP0808X | 394001 | OH | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.