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1447026422 NPI number — KELLY MARIE MARSH APRN-CNP

NPI Number: 1447026422
Health Care Provider/Practitioner: KELLY MARIE MARSH APRN-CNP

Information about “1447026422” NPI (KELLY MARIE MARSH APRN-CNP) exists in 1447026422 in HTML format HTML  |  1447026422 in plain Text format TXT  |  1447026422 in PDF (Portable Document Format) PDF  |  1447026422 in an XML format XML  formats.

NPI Number : 1447026422 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447026422",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MARSH",
    "FirstName": "KELLY",
    "MiddleName": "MARIE",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "APRN-CNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MALM",
    "OtherFirstName": "KELLY",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "700 ACKERMAN RD STE 2120",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBUS",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43202-1559",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "330-325-3202",
    "MailingAddressFaxNumber": "833-606-1565",
    "FirstLinePracticeLocationAddress": "4211 STATE ROUTE 44 STE 203",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROOTSTOWN",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44272-9733",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "330-325-3202",
    "PracticeLocationAddressFaxNumber": "833-606-1565",
    "EnumerationDate": "11/30/2023",
    "LastUpdateDate": "03/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "APRN.CNP.0035164",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "APRN.CNP.0035164",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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