Healthcare Provider Details

I. General information

NPI: 1437789724
Provider Name (Legal Business Name): ALISON KEHLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2020
Last Update Date: 01/25/2020
Certification Date: 01/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 STATE ROUTE 741
MASON OH
45040-2337
US

IV. Provider business mailing address

5210 STATE ROUTE 741
MASON OH
45040-2337
US

V. Phone/Fax

Practice location:
  • Phone: 513-398-8820
  • Fax: 513-398-4815
Mailing address:
  • Phone: 513-398-8820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number019171
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03236968
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: