Healthcare Provider Details

I. General information

NPI: 1174064760
Provider Name (Legal Business Name): KEISHA ROYLES LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

873 OAKFIELD AVE
CINCINNATI OH
45224-1749
US

IV. Provider business mailing address

873 OAKFIELD AVE
CINCINNATI OH
45224-1749
US

V. Phone/Fax

Practice location:
  • Phone: 513-226-4077
  • Fax:
Mailing address:
  • Phone: 513-226-4077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number401854710516
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.179737.MEDS-IV
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberLPN.179737.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: