Provider Demographics
NPI:1548608235
Name:MCANALLY, KELSEY MB (DO)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MB
Last Name:MCANALLY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:MICHELE BOWDEN
Other - Last Name:MCANALLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2035 15TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1738
Mailing Address - Country:US
Mailing Address - Phone:320-656-7100
Mailing Address - Fax:
Practice Address - Street 1:2035 15TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1738
Practice Address - Country:US
Practice Address - Phone:320-656-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3572207R00000X
AZ010619207R00000X
COCDR.0002981207R00000X
GA96748207R00000X
IL36.165975207R00000X
IN02007678A207R00000X
MEDO3817207R00000X
MIEMC0003672207R00000X
MN61316207R00000X
OH34C.000144207R00000X
TN5610207R00000X
UT13489769-1204207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine