Healthcare Provider Details

I. General information

NPI: 1942421466
Provider Name (Legal Business Name): KACEY DAWN KERSTING CNM, WHNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 04/19/2025
Certification Date: 04/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10547 MONTGOMERY RD STE 500-3
MONTGOMERY OH
45242-4418
US

IV. Provider business mailing address

5810 SAMSTONE CT
BLUE ASH OH
45242-5753
US

V. Phone/Fax

Practice location:
  • Phone: 513-400-4333
  • Fax: 855-975-2404
Mailing address:
  • Phone: 513-403-4333
  • Fax: 855-975-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberNM-08939
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberCOA.11705NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.11705
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: