Healthcare Provider Details

I. General information

NPI: 1790877801
Provider Name (Legal Business Name): KRISTINE RENEE ATCHLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9075 CENTRE POINTE DR STE 200
WEST CHESTER OH
45069-4886
US

IV. Provider business mailing address

PO BOX 643398
CINCINNATI OH
45264-3398
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-1100
  • Fax: 513-569-5297
Mailing address:
  • Phone: 513-221-1100
  • Fax: 513-569-5297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.08234
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.08234
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: