Provider Demographics
NPI:1346783149
Name:FALCONE, KELLY SUE (CPNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:SUE
Last Name:FALCONE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 2017
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4567
Mailing Address - Fax:513-636-4786
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 2017
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4567
Practice Address - Fax:513-636-4786
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020332363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics