Individual
KELLIE ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
196 E EMMITT AVE, WAVERLY, OH 45690-1334
(740) 912-9499
Mailing address
505 N HIGH ST, WAVERLY, OH 45690-1130
(740) 708-1563
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
240998
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0029334
OH
Other
Enumeration date
06/27/2018
Last updated
09/10/2021
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