Provider Demographics
NPI:1508454299
Name:AUSTIN, KELLI
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 REPUBLIC ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-6486
Mailing Address - Country:US
Mailing Address - Phone:513-620-2116
Mailing Address - Fax:
Practice Address - Street 1:1619 REPUBLIC ST APT 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-6486
Practice Address - Country:US
Practice Address - Phone:513-578-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000000163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000OtherI'M TRYING TO GET NPI NUMBER
OH000000000OtherJUST STARING