Individual
KELSEY TANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(616) 826-7414
Mailing address
2098 WASCANA AVE, LAKEWOOD, OH 44107-6130
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0039808
OH
Other
Enumeration date
08/01/2025
Last updated
11/21/2025
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