Basic Information
| Provider Information | |||||||||
| NPI: | 1134348097 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAEHR | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 N FOUNTAIN BLVD | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 455041422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373999500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5109 W BROAD ST STE 104 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432281648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142797690 | ||||||||
| FaxNumber: | 6148530438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2007 | ||||||||
| LastUpdateDate: | 12/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/09/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN328458 | OH | N | Nursing Service Providers | Registered Nurse | 163WP0808X | 328458 | OH | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 164W00000X | PN105287IV | OH | N | Nursing Service Providers | Licensed Practical Nurse | 163WP0808X | RN1328458 | OH | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.