Provider Demographics
NPI:1093465502
Name:PRISTAS, KATLYNN A
Entity Type:Individual
Prefix:
First Name:KATLYNN
Middle Name:A
Last Name:PRISTAS
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 1:5312 BRIARHILL DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5606
Mailing Address - Country:US
Mailing Address - Phone:513-910-7589
Mailing Address - Fax:
Practice Address - Street 1:5312 BRIARHILL DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-5606
Practice Address - Country:US
Practice Address - Phone:513-910-7589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-27
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)