Provider Demographics
NPI:1952554610
Name:GHILONI, KRISTA ANN
Entity Type:Individual
Prefix:MISS
First Name:KRISTA
Middle Name:ANN
Last Name:GHILONI
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 1:450 SHERWOOD DOWNS RD S
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3224
Mailing Address - Country:US
Mailing Address - Phone:740-258-0581
Mailing Address - Fax:
Practice Address - Street 1:450 SHERWOOD DOWN S
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3224
Practice Address - Country:US
Practice Address - Phone:740-258-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2849467Medicaid