Individual
KELLIE A KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
452 W 10TH AVENUE, STE 100, COLUMBUS, OH 43210
(614) 293-6638
(614) 293-5614
Mailing address
700 ACKERMAN RD, COLUMBUS, OH 43202-1559
(614) 947-3700
(614) 947-3771
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA07581NP
OH
363LF0000X
Family Nurse Practitioner
07581NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2537964
—
OH
Enumeration date
06/14/2005
Last updated
03/02/2010
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