Healthcare Provider Details

I. General information

NPI: 1346793338
Provider Name (Legal Business Name): KITERIA FINLAYSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 TOD PL NW
WARREN OH
44485-2474
US

IV. Provider business mailing address

1296 TOD PL NW
WARREN OH
44485-2474
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-4643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number58.007947
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.013618
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: