Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-101742 | AL |
NPI | 1033555214 |
---|---|
Provider Name | Christopher Michael Kelsey |
First Address | Hendersonville, TN 37075-8903 |
Second Address | Cullman, AL 35055-5299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2013 |
Last Update Date | 22/07/2016 |