Individual
KRISTA LEE BURRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4101 EDWARDS RD FL 2, CINCINNATI, OH 45209-1678
(513) 981-4646
(513) 979-2830
Mailing address
4101 EDWARDS RD FL 2, CINCINNATI, OH 45209-1678
(513) 981-4646
(513) 979-2830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT222289
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT222289
GRADUATE MEDICAL TRAINEE LICENSE NUMBER
PA
Enumeration date
04/21/2021
Last updated
08/15/2024
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