Individual
NANCY WASSERBAUER KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
19800 DETROIT RD, ROCKY RIVER, OH 44116-1816
(440) 333-1107
(440) 333-1064
Mailing address
26908 DETROIT RD, SUITE 301, WESTLAKE, OH 44145-2398
(440) 617-1823
(440) 617-0884
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
34008802
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2680915
—
OH
Enumeration date
07/27/2006
Last updated
12/08/2020
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