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General NPI Number Information
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NPI Number | 1528449246
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Entity Type | Individual
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Provider Name | KELSEY ALLYSE CARRIERE O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE MLC 4008
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4751
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Fax | 513-636-7911
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE MLC 4008
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4751
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Fax | 513-636-7911
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5090
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OPT.6434-THER
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License Number State | OH
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