Provider Demographics
NPI:1366924292
Name:HALL, KELCEE JAE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KELCEE
Middle Name:JAE
Last Name:HALL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 SYCAMORE WOODS LN
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-7003
Mailing Address - Country:US
Mailing Address - Phone:419-351-0731
Mailing Address - Fax:
Practice Address - Street 1:1661 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-4207
Practice Address - Country:US
Practice Address - Phone:419-843-7800
Practice Address - Fax:419-843-3444
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily