Healthcare Provider Details

I. General information

NPI: 1376176784
Provider Name (Legal Business Name): KELCY TUCKER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELCY HARTBARGER APRN, FNP-C

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE STE 310
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

2139 AUBURN AVE. # 4-7
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-5468
  • Fax: 513-585-5889
Mailing address:
  • Phone: 513-263-9402
  • Fax: 513-564-2918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026324
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: