Provider Demographics
NPI:1477438406
Name:LATHROP, KRYSTIE E
Entity type:Individual
Prefix:
First Name:KRYSTIE
Middle Name:E
Last Name:LATHROP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26244 LUCKEY RD
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-9735
Mailing Address - Country:US
Mailing Address - Phone:419-494-7463
Mailing Address - Fax:
Practice Address - Street 1:26244 LUCKEY RD
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-9735
Practice Address - Country:US
Practice Address - Phone:419-494-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant