Provider Demographics
NPI:1144091117
Name:DEBROW, KELSEY LYNNE (FNP-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNNE
Last Name:DEBROW
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8021 ASHFORD DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2000
Mailing Address - Country:US
Mailing Address - Phone:240-285-5748
Mailing Address - Fax:
Practice Address - Street 1:2296 OPITZ BLVD STE 440
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3355
Practice Address - Country:US
Practice Address - Phone:703-878-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily