Provider Demographics
NPI:1144337056
Name:KELSEY, ASHLEY A (PA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:A
Last Name:KELSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:E
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-6974
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:3003 W DR. MLK JR. BLVD.
Practice Address - Street 2:MAB 2ND FLOOR
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-321-6580
Practice Address - Fax:813-321-6315
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103813363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292552400Medicaid
FLAA284XMedicare PIN
FL292552400Medicaid