Kidd, Kellie A

Kidd, Kellie A is an individual health care provider with primary practice located at 452 W 10Th Avenue Ste 100, Columbus OH 43210. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kidd, Kellie A can be contacted via phone (614) 293-6638.

Contact Information

Primary practice address
452 W 10Th Avenue Ste 100 Columbus OH 43210
Phone: (614) 293-6638
Fax: (614) 293-5614
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 07581NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X COA07581NP Ohio

Profile Details

NPI number 1952306318
LBN Legal business name Kidd, Kellie A
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Mar 2nd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952306318 NPPES
Ohio MEDICAID 2537964

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