Healthcare Provider Details

I. General information

NPI: 1609284165
Provider Name (Legal Business Name): KRISTIN R CAUDILL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN R BROWNING CNP

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CLINE AVE STE 1
MANSFIELD OH
44907-1056
US

IV. Provider business mailing address

380 CLINE AVE STE 1
MANSFIELD OH
44907-1056
US

V. Phone/Fax

Practice location:
  • Phone: 567-474-6302
  • Fax: 419-273-4889
Mailing address:
  • Phone: 567-474-6302
  • Fax: 419-273-4889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16025-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: