MEDICARE: KELSIE LYNN GOLDSCHMIDT

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
1	3747P1801X	Personal Care Attendant		OH

General Provider Information

NPI Number	:	1194684944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSIE LYNN GOLDSCHMIDT

Provider Business Mailing Address
First Line	:	988 FOXTAIL CIR
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-2776
Country	:	US
Telephone Number	:	937-405-3114
Fax Number	:

Provider Business Practice Location Address
First Line	:	852 N WILLOW GLEN AVE
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-1163
Country	:	US
Telephone Number	:	937-506-7269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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