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NPI Code Detail

MEDICARE: MRS. KRISTEN D WHEELER

MEDICARE: MRS. KRISTEN D WHEELER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician16-20098CO
2171M00000XCase Manager/Care Coordinator16-20098CO

General Provider Information

NPI Number : 1215444278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTEN D WHEELER
Provider Business Mailing Address
First Line : 1 HALLORAN PARK LN
Second Line :
City : SAINT CLAIRSVILLE
State : OH
Zip : 43950-1367
Country : US
Telephone Number : 740-296-5743
Fax Number :
Provider Business Practice Location Address
First Line : 1 HALLORAN PARK LN
Second Line :
City : SAINT CLAIRSVILLE
State : OH
Zip : 43950-1367
Country : US
Telephone Number : 740-296-5743
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2017
Last Update Date : 12/29/2017

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Directions to “ MRS. KRISTEN D WHEELER ” Practice Location

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