Individual
MISS KRISTEN LYNNE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3709
(330) 480-2568
Mailing address
PO BOX 636988, CINCINNATI, OH 45263-6988
(888) 940-2722
(513) 632-8898
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-001735
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084823
—
OH
Enumeration date
03/15/2007
Last updated
09/30/2015
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