Provider Demographics
NPI:1386480754
Name:CANTER, KRISTINA J (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:J
Last Name:CANTER
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 AGLER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-4608
Mailing Address - Country:US
Mailing Address - Phone:614-348-5224
Mailing Address - Fax:
Practice Address - Street 1:2436 AGLER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-4608
Practice Address - Country:US
Practice Address - Phone:614-348-5224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty