Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 08935 | OH |
NPI | 1003985391 |
---|---|
Provider Name | Kelly Leigh Scholl |
First Address | Marion, OH 43302-8684 |
Second Address | Marion, OH 43302-8684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 13/11/2013 |