Provider Demographics
NPI:1548972672
Name:MCCARREL, KEIERRAH
Entity type:Individual
Prefix:
First Name:KEIERRAH
Middle Name:
Last Name:MCCARREL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 HIGH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3476
Mailing Address - Country:US
Mailing Address - Phone:614-735-7928
Mailing Address - Fax:
Practice Address - Street 1:3457 HIGH CREEK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3476
Practice Address - Country:US
Practice Address - Phone:614-735-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.439650163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty