Healthcare Provider Details

I. General information

NPI: 1699382572
Provider Name (Legal Business Name): MRS. MARY KREIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 E GALBRAITH RD STE 207
CINCINNATI OH
45236-6706
US

IV. Provider business mailing address

4750 E GALBRAITH RD STE 207
CINCINNATI OH
45236-6706
US

V. Phone/Fax

Practice location:
  • Phone: 513-829-1700
  • Fax: 513-829-5333
Mailing address:
  • Phone: 513-829-1700
  • Fax: 513-829-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0027538
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0027538
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: