Healthcare Provider Details

I. General information

NPI: 1326099839
Provider Name (Legal Business Name): KATHLEEN PATRICIA ROEDER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 HARRISON AVE STE 3500
CINCINNATI OH
45248-1739
US

IV. Provider business mailing address

5885 HARRISON AVE STE 3500
CINCINNATI OH
45248-1739
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-9660
  • Fax: 513-347-2347
Mailing address:
  • Phone: 513-922-9660
  • Fax: 513-347-2347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCOA08267NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.08267
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: