Healthcare Provider Details

I. General information

NPI: 1568372423
Provider Name (Legal Business Name): KELSEY CASE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 PORTLAND WAY N
GALION OH
44833-1115
US

IV. Provider business mailing address

476 PORTLAND WAY N
GALION OH
44833-1115
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-3676
  • Fax:
Mailing address:
  • Phone: 419-468-3676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.360106
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: