Provider Demographics
NPI:1255315040
Name:OUSLEY, KENT A (CRNA)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:A
Last Name:OUSLEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246
Mailing Address - Country:US
Mailing Address - Phone:513-215-1488
Mailing Address - Fax:513-215-1978
Practice Address - Street 1:3300 MERCY HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1103
Practice Address - Country:US
Practice Address - Phone:513-215-1488
Practice Address - Fax:513-215-1978
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1055066163W00000X
OHRN.198180163W00000X
IN28209070A163W00000X
KY44587367500000X
OHCOA.00299-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0941628Medicaid
27150036OtherHEALTHNET
IN200115120Medicaid
000000288574OtherANTHEM BLUE SHIELD
KY74002833Medicaid
000000288574OtherANTHEM BLUE SHIELD
000000288574OtherANTHEM BLUE SHIELD