Kelly Lee Roach in Jefferson - Licensed Practical Nurse
Kelly Lee Roach - NPI 1417077223
Kelly Lee Roach is a Licensed Practical Nurse in Jefferson, Ohio. Kelly Lee Roach practices all healthcare services and medical treatments related to Licensed Practical Nurse. The NPI Number for Kelly Lee Roach is 1417077223. The last update date is 2009-06-18.
Kelly Lee Roach's current location address is 173 W Cedar St, Jefferson, Ohio. You can contact this provider via phone number 4405763066. The mailing address for Kelly Lee Roach is 173 W Cedar St, Jefferson, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Lee Roach |
|---|---|
| Address | 173 W Cedar St, Jefferson, Ohio |
| Phone Number | 4405763066 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LPN |
NPI Number Detail
| NPI Number | 1417077223 |
|---|---|
| Provider Enumeration Date | 2007-03-29 |
| Last Updated Date | 2009-06-18 |
Provider Mailing Address Detail
| Address | 173 W Cedar St |
|---|---|
| City | Jefferson |
| State | Ohio (OH) |
| Post Code | 440471380 |
| Phone Number | 4405763066 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Licensed Practical Nurse |
|---|---|
| Taxonomy | 164W00000X |
| Licence No | PN . 109453 |
|
Definition: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job r |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2286253 | OH | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Kelly Lee Roach by the Centers for Medicare & Medicaid Services (CMS)?
The Kelly Lee Roach has been assigned the NPI (National Provider Identifier) 1417077223. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Kelly Lee Roach is geographically located?
The Kelly Lee Roach is physically situated at the following location: 173 W Cedar St, Jefferson, OH, 440471380.
What is Kelly Lee Roach's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kelly Lee Roach's specialized field of practice is Licensed Practical Nurse, and the corresponding taxonomy code that categorizes this area of specialization is 164W00000X.
On what date did Kelly Lee Roach receive its 1417077223 assignment from the Centers for Medicare & Medicaid Services?
The Kelly Lee Roach was assigned its 1417077223 on 2007-03-29, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Kelly Lee Roach last refreshed?
The information related to the Kelly Lee Roach, including its address, specialty, and other relevant details, was last updated on 2009-06-18.
NPI Number: 1669475885
Address: 1005 Midwestern Pkwy, Wichita Falls, TX
NPI Number: 1285637785
Address: 101 Deer Run Rd, Elgin, SC