Healthcare Provider Details

I. General information

NPI: 1255315040
Provider Name (Legal Business Name): KENT A OUSLEY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MERCY HEALTH BLVD
CINCINNATI OH
45211-1103
US

IV. Provider business mailing address

200 NORTHLAND BLVD
CINCINNATI OH
45246
US

V. Phone/Fax

Practice location:
  • Phone: 513-215-1488
  • Fax: 513-215-1978
Mailing address:
  • Phone: 513-215-1488
  • Fax: 513-215-1978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1055066
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.198180
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28209070A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number44587
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.00299-NA
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: