Individual
KRISTEN M. BYRNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 KIMROSE LN, BROADVIEW HEIGHTS, OH 44147-1258
(440) 334-7806
Mailing address
1215 W 10TH ST, CLEVELAND, OH 44113-1291
(440) 334-7806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007867RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1198730
NCCPA BOARD CERTIFICATION
OH
01
—
50.007867RX
OHIO MEDICAL LICENST
OH
Enumeration date
06/05/2022
Last updated
11/14/2022
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