# KSN PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437969201
- **Authorized official:** KORTO SULONGTEH-NELSON (OWNER)
- **Authorized official phone:** (330) 310-6812

## Contact information

- **Practice address:** 1841 FAIRLAWN KNOLLS DR, AKRON, OH 44313-5435
- **Practice address phone:** (330) 310-6812
- **Practice address fax:** (330) 776-5557
- **Mailing address:** 1841 FAIRLAWN KNOLLS DR, AKRON, OH 44313-5435
- **Mailing address phone:** (330) 310-6812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2025
- **Last updated:** 01/13/2025