Individual
KELLIE CLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 S SOUDER AVE, COLUMBUS, OH 43222-1535
(574) 546-1900
Mailing address
1824 BRIARROSE CT, CINCINNATI, OH 45231-1907
(513) 520-4100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
477656
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0035099
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.0035099
STATE LICENSE
OH
Enumeration date
09/01/2016
Last updated
03/13/2024
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