MEDICARE: KELLI AUSTIN

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	163WS0200X	School Registered Nurse	000000	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00000	OTHER	OH	I'M TRYING TO GET NPI NUMBER
2	000000000	OTHER	OH	JUST STARING

General Provider Information

NPI Number	:	1508454299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI AUSTIN

Provider Business Mailing Address
First Line	:	1619 REPUBLIC ST APT 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-6486
Country	:	US
Telephone Number	:	513-620-2116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 REPUBLIC ST APT 3
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-6486
Country	:	US
Telephone Number	:	513-578-9890
Fax Number	:

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

Provider Enumeration Date	:	01/07/2021
Last Update Date	:	01/07/2021

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Directions to “ KELLI AUSTIN ” Practice Location

Language	Start Address	Practice Location

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