Individual
KELSEY KIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1 MEDICAL CENTER DR FL 3, MIDDLETOWN, OH 45005
(513) 974-6093
(513) 974-5005
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
019641
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0172890
—
OH
Enumeration date
06/09/2016
Last updated
01/28/2019
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