Provider Demographics
NPI:1558073155
Name:FURSTENBERG, KELSEY (CRNP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:FURSTENBERG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9055 CHEVROLET DR STE 203
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4000
Mailing Address - Country:US
Mailing Address - Phone:410-750-9200
Mailing Address - Fax:410-720-9211
Practice Address - Street 1:9055 CHEVROLET DR STE 203
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4000
Practice Address - Country:US
Practice Address - Phone:410-750-9200
Practice Address - Fax:410-720-9211
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily