Healthcare Provider Details

I. General information

NPI: 1962004374
Provider Name (Legal Business Name): CHELSEA L KAHLE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 W HIGH ST STE 350
LIMA OH
45801-5901
US

IV. Provider business mailing address

770 W HIGH ST STE 350
LIMA OH
45801-5901
US

V. Phone/Fax

Practice location:
  • Phone: 419-228-8950
  • Fax: 419-224-7904
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.002783
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: