Provider Demographics
NPI:1134823545
Name:RECTOR, KELLI
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:RECTOR
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 1:612 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45107-1332
Mailing Address - Country:US
Mailing Address - Phone:513-630-6362
Mailing Address - Fax:
Practice Address - Street 1:612 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BLANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45107-1332
Practice Address - Country:US
Practice Address - Phone:513-630-6362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker