| Ms Kelly Marie Marsh, APRN-CNP | |
| 
					4211 State Route 44 Ste 203, Rootstown, OH 44272-9733  | |
| (330) 325-3202 | |
| (833) 606-1565 | 
| Full Name | Ms Kelly Marie Marsh | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Psychiatric/mental Health | 
| Location | 4211 State Route 44 Ste 203, Rootstown, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1447026422 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363L00000X | Nurse Practitioner | APRN.CNP.0035164 (Ohio) | Secondary | 
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | APRN.CNP.0035164 (Ohio) | Primary | 
| Entity Name | Osup Community Outreach Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1699179929 PECOS PAC ID: 5799008082 Enrollment ID: O20141217001070  | 
| Entity Name | Alcove Ventures Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1093191322 PECOS PAC ID: 1456669605 Enrollment ID: O20151007002805  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ms Kelly Marie Marsh, APRN-CNP 700 Ackerman Rd Ste 2120, Columbus, OH 43202-1559 Ph: (330) 325-3202  | Ms Kelly Marie Marsh, APRN-CNP 4211 State Route 44 Ste 203, Rootstown, OH 44272-9733 Ph: (330) 325-3202  | 
Mr. Shawn Cedric Richards, APRN-CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4211 State Route 44 Ste 203, Rootstown, OH 44272 Phone: 330-325-3202 Fax: 833-606-1565  | |
Michelle Lea Tobias, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4211 State Route 44 Unit 1550, Rootstown, OH 44272 Phone: 330-325-7171  | |
Leah Marie Minard, APRN-CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4211 State Route 44, Rootstown, OH 44272 Phone: 330-325-3202 Fax: 833-606-1565  | |
Ashley Marie Miller, ARPN-FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4211 State Route 44 Ste 203, Rootstown, OH 44272 Phone: 330-325-3202 Fax: 833-606-1565  |