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Individual

KRISTEN NICOLE WAITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
272 BENEDICT AVE, NORWALK, OH 44857-2374
(419) 668-8101
Mailing address
1508 AQUA MARINE BLVD, AVON LAKE, OH 44012-2569
(440) 465-1999

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005250RX
OH

Other

Enumeration date
06/19/2017
Last updated
07/21/2022
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