Provider Demographics
NPI:1609527696
Name:YOST, KRISTEN L (PAC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:YOST
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NEWARK GRANVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-7009
Mailing Address - Country:US
Mailing Address - Phone:740-587-0087
Mailing Address - Fax:740-587-0084
Practice Address - Street 1:2000 NEWARK GRANVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-7009
Practice Address - Country:US
Practice Address - Phone:740-587-0087
Practice Address - Fax:740-587-0084
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008006363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant