MEDICARE: KELSEY SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	L8-0010934	DE

General Provider Information

NPI Number	:	1093651572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY SMITH

Provider Business Mailing Address
First Line	:	19 CAPANO DR APT A4
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19702-1854
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 BANNING ST
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19904-3457
Country	:	US
Telephone Number	:	302-677-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	05/07/2026

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Directions to “ KELSEY SMITH ” Practice Location

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