Provider Demographics
NPI:1528317179
Name:SONNABEND, KELSEY NICOLE (NP)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:NICOLE
Last Name:SONNABEND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 LESLIE DR
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-6509
Mailing Address - Country:US
Mailing Address - Phone:480-389-8693
Mailing Address - Fax:
Practice Address - Street 1:7450 OH-161
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064
Practice Address - Country:US
Practice Address - Phone:614-504-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN174310163W00000X
OH0034667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse