Healthcare Provider Details

I. General information

NPI: 1528449246
Provider Name (Legal Business Name): KELSEY ALLYSE CARRIERE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY ALLYSE THOMSON O.D.

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 4008
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE MLC 4008
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4751
  • Fax: 513-636-7911
Mailing address:
  • Phone: 513-636-4751
  • Fax: 513-636-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberOPT.6434-THER
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.006434
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: