Healthcare Provider Details

I. General information

NPI: 1649188350
Provider Name (Legal Business Name): KRISTEN JOANNE EWING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 WADE AVE
ASHTABULA OH
44004-9435
US

IV. Provider business mailing address

2308 WADE AVE
ASHTABULA OH
44004-9435
US

V. Phone/Fax

Practice location:
  • Phone: 440-992-1275
  • Fax: 440-992-1272
Mailing address:
  • Phone: 440-992-1275
  • Fax: 440-992-1272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.313237
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: