Provider Demographics
NPI:1861915357
Name:BUDANOV, KRISTA (NP-C)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:BUDANOV
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:SATOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9312 PIERCE RD
Mailing Address - Street 2:
Mailing Address - City:GARRETTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44231-9478
Mailing Address - Country:US
Mailing Address - Phone:330-350-2600
Mailing Address - Fax:
Practice Address - Street 1:1 MEMORY LN
Practice Address - Street 2:
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231-9443
Practice Address - Country:US
Practice Address - Phone:330-527-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021245363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner