Provider Demographics
NPI:1821218447
Name:MCDONALD, KRISTA (ARNP)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 ENGLE RD BLDG 6-601
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-8491
Mailing Address - Country:US
Mailing Address - Phone:216-206-7507
Mailing Address - Fax:864-448-1616
Practice Address - Street 1:7055 ENGLE RD BLDG 6-601
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8491
Practice Address - Country:US
Practice Address - Phone:216-206-7507
Practice Address - Fax:864-448-1616
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2025-08-13
Deactivation Date:2025-07-07
Deactivation Code:
Reactivation Date:2025-07-24
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9427463363LF0000X
NJ26NJ00450700363LF0000X
FL9427463363LP0808X
OHAPRN.CNP.0031227363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily