Provider Demographics
NPI:1538710512
Name:CALL, KIRSTON LYNNE (CNP)
Entity type:Individual
Prefix:
First Name:KIRSTON
Middle Name:LYNNE
Last Name:CALL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 RAVENNA RD
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-5768
Mailing Address - Country:US
Mailing Address - Phone:330-338-3661
Mailing Address - Fax:
Practice Address - Street 1:191 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-5768
Practice Address - Country:US
Practice Address - Phone:330-338-3661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH341914163W00000X
OHAPRN.CNP.025548363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse