Healthcare Provider Details

I. General information

NPI: 1538493309
Provider Name (Legal Business Name): CHRISTOPHER J KALB, CNP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 YORKSHIRE DR
LIMA OH
45804-3378
US

IV. Provider business mailing address

757 YORKSHIRE DR
LIMA OH
45804-3378
US

V. Phone/Fax

Practice location:
  • Phone: 419-225-9935
  • Fax:
Mailing address:
  • Phone: 419-225-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP08571
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. CHRISTOPHER J KALB
Title or Position: PRESIDENT
Credential: CNP
Phone: 419-225-9935