Individual
MRS. TISHA MARIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
272 ESSEX RD, VERMILION, OH 44089-2234
(440) 653-1452
Mailing address
272 ESSEX RD, VERMILION, OH 44089-2234
(440) 653-1452
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
602887461024
OH
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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