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General NPI Number Information
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NPI Number | 1275206039
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Entity Type | Individual
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Provider Name | KELLY D BRILL APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 159 CROCKER PARK BLVD STE 400
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City | WESTLAKE
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State | OH
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Zip | 44145-8147
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Country | US
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Telephone | 440-864-2802
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Fax | 440-287-6137
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Provider Business Mailing Address
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Address Line | 159 CROCKER PARK BLVD STE 400
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City | WESTLAKE
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State | OH
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Zip | 44145-8147
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Country | US
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Telephone | 440-864-2802
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Fax | 440-287-6137
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0031831
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.384208
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License Number State | OH
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