Healthcare Provider Details

I. General information

NPI: 1518696426
Provider Name (Legal Business Name): SARAH KELM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE
CINCINNATI OH
45219-2989
US

IV. Provider business mailing address

2139 AUBURN AVENUE ATTN: PAYOR ENROLLMENT 4-7
CINCINNATI OH
45219
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-0449
  • Fax: 513-585-4099
Mailing address:
  • Phone: 513-351-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0031588
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number351928
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: