Provider Demographics
NPI:1144728965
Name:CAIN, KELSIE O (APRN)
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:O
Last Name:CAIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KELSIE
Other - Middle Name:O
Other - Last Name:EDSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4990
Mailing Address - Country:US
Mailing Address - Phone:812-945-4000
Mailing Address - Fax:812-941-5714
Practice Address - Street 1:3532 EPHRAIM MCDOWELL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3224
Practice Address - Country:US
Practice Address - Phone:800-264-0521
Practice Address - Fax:502-456-6655
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28241097A363LF0000X
IN71007827A363LF0000X
KY3013158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily