Provider Demographics
NPI:1497209928
Name:FINK, KELLY LYNORE ROSENTHAL (PMHNP-BC, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNORE ROSENTHAL
Last Name:FINK
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:LYNORE
Other - Last Name:ROSENTHAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:304 S JONES BLVD # 1654
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2623
Mailing Address - Country:US
Mailing Address - Phone:702-721-9641
Mailing Address - Fax:
Practice Address - Street 1:2211 NW PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3891
Practice Address - Country:US
Practice Address - Phone:458-272-1361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-13
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002358363LP0808X
OR10038846363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health