Healthcare Provider Details

I. General information

NPI: 1407433568
Provider Name (Legal Business Name): EMILY KITSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST STE 215
AKRON OH
44304-1467
US

IV. Provider business mailing address

95 ARCH ST STE 215
AKRON OH
44304-1467
US

V. Phone/Fax

Practice location:
  • Phone: 330-434-4145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006853RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: