MEDICARE: KELCEY L ST. AMAND CNM

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	367A00000X	Advanced Practice Midwife	0024186962	VA

General Provider Information

NPI Number	:	1568246817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELCEY L ST. AMAND CNM

Provider Business Mailing Address
First Line	:	860 OMNI BLVD STE 401
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4430
Country	:	US
Telephone Number	:	757-232-8860
Fax Number	:	757-232-8875

Provider Business Practice Location Address
First Line	:	11842 ROCK LANDING DR STE 115
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4437
Country	:	US
Telephone Number	:	757-595-9905
Fax Number	:

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

Provider Enumeration Date	:	08/18/2023
Last Update Date	:	02/11/2026

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