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General NPI Number Information
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NPI Number | 1528317179
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Entity Type | Individual
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Provider Name | KELSEY NICOLE SONNABEND NP
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Gender | Female
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 7450 OH-161
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City | PLAIN CITY
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State | OH
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Zip | 43064
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Country | US
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Telephone | 614-504-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 LESLIE DR
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City | PLAIN CITY
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State | OH
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Zip | 43064-6509
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Country | US
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Telephone | 480-389-8693
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0034667
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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 | RN174310
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License Number State | AZ
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