Healthcare Provider Details

I. General information

NPI: 1356586275
Provider Name (Legal Business Name): KRISTEN C. PUHLMAN R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12300 MCCRACKEN RD SUITE 253
GARFIELD HEIGHTS OH
44125-2914
US

IV. Provider business mailing address

12500 MCCRACKEN DRIVE SUITE 253
GARFIELD HEIGHTS OH
44125
US

V. Phone/Fax

Practice location:
  • Phone: 216-587-8246
  • Fax: 216-584-4372
Mailing address:
  • Phone: 216-587-8246
  • Fax: 216-584-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD5426
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: