Healthcare Provider Details

I. General information

NPI: 1871361568
Provider Name (Legal Business Name): CHRISTIAN KONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 S PATTERSON BLVD
DAYTON OH
45402-2624
US

IV. Provider business mailing address

732 BECKMAN ST
DAYTON OH
45410-2165
US

V. Phone/Fax

Practice location:
  • Phone: 937-966-4673
  • Fax:
Mailing address:
  • Phone: 937-253-1680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number196583
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: