Provider Demographics
NPI:1619379526
Name:KRIEG, ERIN N
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:N
Last Name:KRIEG
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 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7608
Practice Address - Street 1:148 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3734
Practice Address - Country:US
Practice Address - Phone:740-346-2702
Practice Address - Fax:740-346-2645
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014447363LF0000X
WVAPRN71274-NP-C363LF0000X
OHAPRN.CNP.16701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102984736Medicaid
OH0111865Medicaid
WV3810028329Medicaid
PA39177YGC9Medicare PIN
WVWV4869AMedicare PIN
OH0111865Medicaid
OHH394900Medicare PIN