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NPI Code Detail

MEDICARE: KESHA P KELLEY

MEDICARE:   KESHA P KELLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376K00000XNurse's Aide

General Provider Information

NPI Number : 1184375933
Entity Type Code : Individual
Provider Name (Legal Business Name) : KESHA P KELLEY
Provider Business Mailing Address
First Line : 2948 MADISON RD APT 305
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-2061
Country : US
Telephone Number : 513-379-9791
Fax Number :
Provider Business Practice Location Address
First Line : 2948 MADISON RD APT 305
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-2061
Country : US
Telephone Number : 513-379-9791
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2022
Last Update Date : 01/13/2022

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Directions to “ KESHA P KELLEY ” Practice Location

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