MEDICARE: KRISTINA GAIL BRIEN

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
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1851123830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA GAIL BRIEN

Provider Business Mailing Address
First Line	:	10950 TOWNSHIP ROAD 235
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-9785
Country	:	US
Telephone Number	:	567-674-0790
Fax Number	:

Provider Business Practice Location Address
First Line	:	10950 TOWNSHIP ROAD 235
Second Line	:
City	:	KENTON
State	:	OH
Zip	:	43326-9785
Country	:	US
Telephone Number	:	567-674-0790
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2024
Last Update Date	:	08/17/2024

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Directions to “ KRISTINA GAIL BRIEN ” Practice Location

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