Provider Demographics
NPI:1174187389
Name:HOLTEL, KELLY BRIANNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:BRIANNA
Last Name:HOLTEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45204-2052
Mailing Address - Country:US
Mailing Address - Phone:513-357-2808
Mailing Address - Fax:
Practice Address - Street 1:2136 W 8TH ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45204-2052
Practice Address - Country:US
Practice Address - Phone:513-357-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372007163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool