Provider Demographics
NPI:1275822447
Name:MEECE, ERINN KELLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:ERINN
Middle Name:KELLEY
Last Name:MEECE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERINN
Other - Middle Name:ELIZABETH
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2139 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:137-915-2005
Mailing Address - Fax:513-791-5229
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-791-5200
Practice Address - Fax:513-791-5229
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1965363A00000X, 363AS0400X
OH50.003542363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151507Medicaid
KY7100379180Medicaid
KY7100379180Medicaid
KYK153730Medicare PIN
TN103I979672Medicare PIN