Healthcare Provider Details

I. General information

NPI: 1164034864
Provider Name (Legal Business Name): BRITTANY ANN KELLUM DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 E GALBRAITH RD
CINCINNATI OH
45236-6703
US

IV. Provider business mailing address

4760 E GALBRAITH RD STE 212
CINCINNATI OH
45236-6704
US

V. Phone/Fax

Practice location:
  • Phone: 513-829-1700
  • Fax:
Mailing address:
  • Phone: 513-829-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0040617
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: