Individual
KELLY O'BRIEN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
479 PARSONS AVE, COLUMBUS, OH 43215-5577
(614) 722-5136
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-6200
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.019572
OH
363LP2300X
Primary Care Nurse Practitioner
APRN.CNP.019572
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188102
—
OH
01
—
H524110
CGS MEDICARE
OH
Enumeration date
08/09/2016
Last updated
02/24/2022
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