Provider Demographics
NPI:1801184833
Name:DOBSON, KRISTY LYNN (NP)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LYNN
Last Name:DOBSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MARKET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2881
Mailing Address - Country:US
Mailing Address - Phone:740-282-5000
Mailing Address - Fax:740-282-5233
Practice Address - Street 1:401 MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2881
Practice Address - Country:US
Practice Address - Phone:740-282-5000
Practice Address - Fax:740-282-5233
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV67589363LF0000X
PASP011582363L00000X
OHAPRN.CNP.13517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810021070Medicaid
OH0051779Medicaid
OH0051779Medicaid
WVWV0455CMedicare PIN