Basic Information
| Provider Information | |||||||||
| NPI: | 1346981545 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEEKS | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | SUSAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER | ||||||||
| Address2: | 395 W 12TH AVENUE, THIRD FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933989 | ||||||||
| FaxNumber: | 6142939789 | ||||||||
| Practice Location | |||||||||
| Address1: | THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER | ||||||||
| Address2: | 395 W 12TH AVENUE, THIRD FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933989 | ||||||||
| FaxNumber: | 6142939789 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2022 | ||||||||
| LastUpdateDate: | 04/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.