Basic Information
| Provider Information | |||||||||
| NPI: | 1104598242 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIEP | ||||||||
| FirstName: | ROSEANN | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | APN, PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 540 SOUTHWOOD DR | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450133710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8126210351 | ||||||||
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| Practice Location | |||||||||
| Address1: | 285 BIELBY RD | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 470251055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8125371302 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2021 | ||||||||
| LastUpdateDate: | 09/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 28130290A | IN | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | 71011558A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.