Provider Demographics
NPI:1356130850
Name:KELSEY, KATELYN
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:
Last Name:KELSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 SAMUEL DR
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1488
Mailing Address - Country:US
Mailing Address - Phone:609-949-4219
Mailing Address - Fax:
Practice Address - Street 1:67 SAMUEL DR
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1488
Practice Address - Country:US
Practice Address - Phone:609-949-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program