Provider Demographics
NPI:1528449246
Name:CARRIERE, KELSEY ALLYSE (OD)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ALLYSE
Last Name:CARRIERE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KELSEY
Other - Middle Name:ALLYSE
Other - Last Name:THOMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:MLC 4008
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4751
Mailing Address - Fax:513-636-7911
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 4008
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4751
Practice Address - Fax:513-636-7911
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5090152W00000X
OHOPT.6434-THER152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152W00000XEye and Vision Services ProvidersOptometrist