MEDICARE: MRS. KRISTIN LOUDEN CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AG08200190	OH

General Provider Information

NPI Number	:	1265022941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN LOUDEN CNP

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # M61
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-445-1757
Fax Number	:	216-636-1588

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # M61
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2516
Country	:	US
Telephone Number	:	216-445-3136
Fax Number	:	216-636-1588

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	11/05/2023

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