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Kelly South
Nurse Practitioner in Kettering, Ohio
NPI 1205203270

Kelly South is a Nurse Practitioner based in Miamisburg, OH. Kelly South practices in Kettering, OH. The NPI Number for Kelly South is 1205203270 and holds a License No. COA.17881 (Ohio).

The current practice location address for Kelly South is 3535 Southern Blvd, Kettering, OH and can be reached out via phone at 937-395-8166 and via fax at 937-395-8347.

Location: 3535 Southern Blvd, Kettering, OH, 45342-5400
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205203270
Provider Name
Kelly South
Credential
Provider Entity Type
Individual
Gender
Female
Address
3535 Southern Blvd, Kettering, OH, 45342-5400
Phone Number
937-395-8166
Fax Number
937-395-8347
Provider Enumeration Date
08/26/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0144636 05 OH
institution
Provider Business Practice Location Address Details
Address
3535 Southern Blvd
City
Kettering
State
Ohio
Zip
45429-1221
Phone Number
937-395-8166
Fax Number
937-395-8347
person
Provider Business Mailing Address Details
Address
3535 Southern Blvd
City
Kettering
State
Ohio
Zip
45429-1221
Phone Number
937-395-8166
Fax Number
937-395-8347
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
COA.17881 (Ohio)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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