Provider Demographics
NPI:1861812174
Name:THRUSH, KELSEY RENEE (DO)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:RENEE
Last Name:THRUSH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 MASSACHUSETTS AVE NW APT 514
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-5808
Mailing Address - Country:US
Mailing Address - Phone:717-372-9845
Mailing Address - Fax:
Practice Address - Street 1:101 E CHARLES ST STE 104
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4901
Practice Address - Country:US
Practice Address - Phone:301-609-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034719207V00000X
MDH84944207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology