Provider Demographics
NPI:1033006143
Name:MIREE, KERRY D
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:D
Last Name:MIREE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 OAK SPRING DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-7113
Mailing Address - Country:US
Mailing Address - Phone:513-883-3625
Mailing Address - Fax:
Practice Address - Street 1:3540 OAK SPRING DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-7113
Practice Address - Country:US
Practice Address - Phone:513-883-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)