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NPI Code Detail

MEDICARE: MRS. LARISSA MARIE KAHLE P.A.-C

MEDICARE: MRS. LARISSA MARIE KAHLE P.A.-C
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
1363AM0700XMedical Physician AssistantPA839KY
2363A00000XPhysician Assistant50-00-2067OH

General Provider Information

NPI Number : 1386647261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LARISSA MARIE KAHLE P.A.-C
Provider Business Mailing Address
First Line : 5583 JAMIES OAK DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-1067
Country : US
Telephone Number : 513-574-4445
Fax Number :
Provider Business Practice Location Address
First Line : 10500 MONTGOMERY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-4402
Country : US
Telephone Number : 513-745-1307
Fax Number : 513-745-1444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 09/11/2025

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Directions to “ MRS. LARISSA MARIE KAHLE P.A.-C” Practice Location

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