Healthcare Provider Details

I. General information

NPI: 1275824641
Provider Name (Legal Business Name): KRISTINE BUSSE ZITELLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINE LYNNE BUSSE

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 E KEMPER RD STE A
CINCINNATI OH
45249-1684
US

IV. Provider business mailing address

8350 E KEMPER RD STE A
CINCINNATI OH
45249-1684
US

V. Phone/Fax

Practice location:
  • Phone: 512-202-3883
  • Fax:
Mailing address:
  • Phone: 512-202-3883
  • Fax: 513-296-6894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.125434
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: