Roach, Kelly Lee

Roach, Kelly Lee is an sole proprietor health care provider with primary practice located at 173 W Cedar St , Jefferson OH 44047-1380. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Roach, Kelly Lee can be contacted via phone (440) 576-3066.

Contact Information

Primary practice address
173 W Cedar St Jefferson OH 44047-1380
Phone: (440) 576-3066
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN . 109453 Ohio

Profile Details

NPI number 1417077223
LBN Legal business name Roach, Kelly Lee
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2007
Last updated Jun 18th, 2009 - about 15 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 1417077223 NPPES
Ohio MEDICAID 2286253

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