Provider Demographics
NPI:1851123830
Name:BRIEN, KRISTINA GAIL
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:GAIL
Last Name:BRIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 TOWNSHIP ROAD 235
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-9785
Mailing Address - Country:US
Mailing Address - Phone:567-674-0790
Mailing Address - Fax:
Practice Address - Street 1:10950 TOWNSHIP ROAD 235
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-9785
Practice Address - Country:US
Practice Address - Phone:567-674-0790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker