Provider Demographics
NPI:1447026422
Name:MARSH, KELLY MARIE (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:MARIE
Last Name:MARSH
Suffix:
Gender:
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:MARIE
Other - Last Name:MALM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:330-325-3202
Mailing Address - Fax:833-606-1565
Practice Address - Street 1:4211 STATE ROUTE 44 STE 203
Practice Address - Street 2:
Practice Address - City:ROOTSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44272-9733
Practice Address - Country:US
Practice Address - Phone:330-325-3202
Practice Address - Fax:833-606-1565
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035164363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner