Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tracy Kellam

Individual provider Contractor · NPI 1104498344

Tracy Kellam is a Contractor in Youngstown, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2021
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Practice location Address checks out

4120 Euclid Blvd
Youngstown, OH 44512-1305
Phone: (330) 984-1505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X · Licence 0325993 (OH)

Record details

NPI number1104498344
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 16, 2021
Last updated in NPPESJuly 16, 2021
Certification dateJuly 16, 2021
Mailing address4120 Euclid Blvd, Youngstown, OH 44512-1305

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