Provider Demographics
NPI:1205727161
Name:MCGRADY, KRISTIN RENEE (RN)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:RENEE
Last Name:MCGRADY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:RENEE
Other - Last Name:CLEMENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:541 SYDNEY PL
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1553
Mailing Address - Country:US
Mailing Address - Phone:330-714-5494
Mailing Address - Fax:
Practice Address - Street 1:18660 BAGLEY RD STE 404
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3483
Practice Address - Country:US
Practice Address - Phone:330-690-9311
Practice Address - Fax:440-234-8748
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.366259163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse