MEDICARE: MRS. KATHLEEN PATRICIA ROEDER CNP

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
1	363L00000X	Nurse Practitioner	COA08267NP	OH
2	363LA2100X	Acute Care Nurse Practitioner	APRN.CNP.08267	OH

General Provider Information

NPI Number	:	1326099839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN PATRICIA ROEDER CNP

Provider Business Mailing Address
First Line	:	5885 HARRISON AVE STE 3500
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1739
Country	:	US
Telephone Number	:	513-922-9660
Fax Number	:	513-347-2347

Provider Business Practice Location Address
First Line	:	5885 HARRISON AVE STE 3500
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1739
Country	:	US
Telephone Number	:	513-922-9660
Fax Number	:	513-347-2347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	10/28/2025

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