Provider Demographics
NPI:1427382498
Name:BILL, KRISTIN ANN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:ANN
Last Name:BILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:ANN
Other - Last Name:PHLEGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 167374
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-7374
Mailing Address - Country:US
Mailing Address - Phone:419-810-3247
Mailing Address - Fax:
Practice Address - Street 1:1328 FELT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-3436
Practice Address - Country:US
Practice Address - Phone:419-810-3247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN104277164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse