Provider Demographics
NPI:1053036384
Name:GETZ, KRISTY RENEE (RN, BSN)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:RENEE
Last Name:GETZ
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 NEEDHAM RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44904-9505
Mailing Address - Country:US
Mailing Address - Phone:419-543-1113
Mailing Address - Fax:
Practice Address - Street 1:3845 NEEDHAM RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:44904-9505
Practice Address - Country:US
Practice Address - Phone:419-543-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH452047163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH452047Medicaid