Provider Demographics
NPI:1164971693
Name:CREAMER, KRISTIANA
Entity Type:Individual
Prefix:
First Name:KRISTIANA
Middle Name:
Last Name:CREAMER
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 1:416 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-1350
Mailing Address - Country:US
Mailing Address - Phone:567-674-3427
Mailing Address - Fax:
Practice Address - Street 1:416 N HIGH ST
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1350
Practice Address - Country:US
Practice Address - Phone:567-674-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH389711163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse