1. Home
  2. Directory
  3. Ohio
  4. Jefferson
  5. Licensed Practical Nurse
  6. NPI Profile

MRS. KELLY LEE ROACH LPN
NPI 1417077223
Licensed Practical Nurse in Jefferson, OH

Active since March 29, 2007
173 W CEDAR ST, JEFFERSON, OH 44047(440) 576-3066 Get Directions Write a Review

NPPES record last updated: June 18, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Kelly Lee Roach Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KELLY LEE ROACH LPN (NPI 1417077223) is an individual licensed practical nurse in Jefferson, Ohio, licensed in Ohio (PN . 109453) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1417077223
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameMRS. KELLY LEE ROACHCredential: LPN
Location Address173 W CEDAR STJefferson, OH 44047-1380
Mailing Address173 W Cedar StJefferson, OH 44047-1380 · (440) 576-3066
Phone(440) 576-3066
Sole ProprietorYes
Enumeration DateMarch 29, 2007
Last NPPES UpdateJune 18, 2009
✔ NPI 1417077223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in OH · PN . 109453
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
173 W CEDAR ST, Jefferson, OH 44047
Open in Google Maps ↗

Other Identifiers 1

Medicaid2286253OH

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Roach's NPI number?

The NPI number for Kelly Roach is 1417077223. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Kelly Roach located?

Kelly Roach practices at 173 W Cedar St, Jefferson, OH 44047. The listed phone number is (440) 576-3066.

What is Kelly Roach's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kelly Roach was last updated on June 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.