Provider Demographics
NPI:1770463572
Name:BENNETT-HUSBAND, KELSEY ELAINE (RN)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELAINE
Last Name:BENNETT-HUSBAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:ELAINE
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2112 E MONTE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2878
Mailing Address - Country:US
Mailing Address - Phone:774-276-2218
Mailing Address - Fax:
Practice Address - Street 1:2112 E MONTE VISTA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2878
Practice Address - Country:US
Practice Address - Phone:774-276-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ232864163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse