Provider Demographics
NPI:1144530536
Name:ORTOPAN, KRISTIN JEANNE (PA-C, MSHS)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JEANNE
Last Name:ORTOPAN
Suffix:
Gender:F
Credentials:PA-C, MSHS
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:JEANNE
Other - Last Name:READENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MSHS
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12301 SNOW RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-1002
Practice Address - Country:US
Practice Address - Phone:216-362-2123
Practice Address - Fax:216-362-2779
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003175363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant