Healthcare Provider Details

I. General information

NPI: 1881995496
Provider Name (Legal Business Name): KRISANA KRAMSEANG RN, MSN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 SPRINGSIDE DR SUITE 204
AKRON OH
44333-4530
US

IV. Provider business mailing address

12465 DEER CREEK DR
NORTH ROYALTON OH
44133-6776
US

V. Phone/Fax

Practice location:
  • Phone: 330-666-9544
  • Fax: 330-670-8569
Mailing address:
  • Phone: 330-608-7438
  • Fax: 330-670-8569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA 11787-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: