Healthcare Provider Details

I. General information

NPI: 1649304262
Provider Name (Legal Business Name): SHARI M KEHRES RN, MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 CHILDREN DR BLDG D
MASON OH
45040-6791
US

IV. Provider business mailing address

9600 CHILDREN DR BLDG D
MASON OH
45040-6791
US

V. Phone/Fax

Practice location:
  • Phone: 513-336-6700
  • Fax: 513-398-2109
Mailing address:
  • Phone: 513-336-6700
  • Fax: 513-398-2109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.06121
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP-06121
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: