Provider Demographics
NPI:1669038139
Name:KONTOS, KRISTEN (CNP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:KONTOS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8888 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2210
Mailing Address - Country:US
Mailing Address - Phone:440-413-2136
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1078
Practice Address - Country:US
Practice Address - Phone:216-906-9626
Practice Address - Fax:216-636-2061
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRNCNP024170363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health