Healthcare Provider Details

I. General information

NPI: 1225944879
Provider Name (Legal Business Name): KELSEY REIFENBERGER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 EATON AVE
HAMILTON OH
45013-2767
US

IV. Provider business mailing address

8001 N DWYER RD
OKEANA OH
45053-9363
US

V. Phone/Fax

Practice location:
  • Phone: 513-376-2082
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN.525962
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: