Provider Demographics
NPI:1487814471
Name:KILCHENMANN, CHRISTINE ERIKA (APRNCNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ERIKA
Last Name:KILCHENMANN
Suffix:
Gender:F
Credentials:APRNCNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:329 WESTLAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-3375
Mailing Address - Country:US
Mailing Address - Phone:330-209-6280
Mailing Address - Fax:
Practice Address - Street 1:5878 FULTON DR NW STE C
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-4305
Practice Address - Country:US
Practice Address - Phone:330-433-9112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33 015872225700000X
OHAPRN.CNP.0029508363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty