Healthcare Provider Details

I. General information

NPI: 1861623902
Provider Name (Legal Business Name): KRISTINA W. HESSER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 KRUPP DR
FAYETTEVILLE OH
45118-9442
US

IV. Provider business mailing address

801 MIAMI AVE
TERRACE PARK OH
45174-1224
US

V. Phone/Fax

Practice location:
  • Phone: 513-875-8002
  • Fax:
Mailing address:
  • Phone: 513-831-8831
  • Fax: 513-831-0375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN158773
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: