Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimyata Latrice Pettaway

Individual provider Community Health Registered Nurse · NPI 1093213738

Kimyata Latrice Pettaway is a Community Health Registered Nurse in Toledo, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2018
Specialties on file
2

Practice location Address checks out

2005 Ashland Ave
Toledo, OH 43620-1703
Phone: (419) 841-7701
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence RN.446147 (OH)
Community Health Registered Nurse Taxonomy 163WC1500X · Licence RN.446147 (OH)

Record details

NPI number1093213738
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 29, 2018
Last updated in NPPESMay 2, 2023
Certification dateMay 2, 2023

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