Kellie Adams
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Waverly, OH
NPI 1629563176 · NPPES record last updated Sep 10, 2021
Key facts
- NPI
- 1629563176
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN.CNP.0029334 (OH)
- Practice address
- 196 E Emmitt Ave
Waverly, OH 45690-1334 - Phone
- (740) 912-9499
- NPI assigned
- Jun 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240998 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 240998 | OH | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN.CNP.0029334 | OH | Yes |
Addresses
Primary practice location
196 E Emmitt Ave
Waverly, OH 45690-1334
Mailing address
505 N High St
Waverly, OH 45690-1130
Phone (740) 708-1563
Other providers in Waverly, OH
- Tina M Ackley
- Hunter Allen Adams
- Jamie Adams
- Adena Health System
- Adena Health System
- Adena Pharmacy LLC
- Amanda Adkins
- Ashley Adkins
All providers in Waverly, OH · Psychiatric/Mental Health Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.