Basic Information
Provider Information
NPI: 1770027591
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LELII
FirstName: REBECCA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVE ML 5021
Address2:  
City: CINCINNATI
State: OH
PostalCode: 45229
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3333 BURNET AVE ML 2008
Address2:  
City: CINCINNATI
State: OH
PostalCode: 45229
CountryCode: US
TelephoneNumber: 5136367966
FaxNumber: 5136367967
Other Information
ProviderEnumerationDate: 12/13/2016
LastUpdateDate: 11/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XAPRN-CNP.17678OHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363L00000XAPRN.CNP.17678OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home