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NPI Code Detail

MEDICARE: KELLI SCHAAR-EVISTON ARNP

MEDICARE: KELLI SCHAAR-EVISTON ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse1092435KY
2363L00000XNurse Practitioner3003042KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265499669
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI SCHAAR-EVISTON ARNP
Provider Business Mailing Address
First Line : 2300 CHAMBER CENTER DRIVE
Second Line : SUITE 200
City : FORT MITCHELL
State : KY
Zip : 41017-1673
Country : US
Telephone Number : 859-344-5555
Fax Number : 859-655-4395
Provider Business Practice Location Address
First Line : 5522 TAYLOR MILL RD
Second Line :
City : TAYLOR MILL
State : KY
Zip : 41015-4604
Country : US
Telephone Number : 859-491-2855
Fax Number : 859-655-4395
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 09/26/2014

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