Healthcare Provider Details

I. General information

NPI: 1831845973
Provider Name (Legal Business Name): KELSEY REIS METZMEIER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY ANN REIS

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6648 CASTLE GREEN PL
ZEPHYRHILLS FL
33541-2764
US

IV. Provider business mailing address

6648 CASTLE GREEN PL
ZEPHYRHILLS FL
33541-2764
US

V. Phone/Fax

Practice location:
  • Phone: 813-451-5766
  • Fax:
Mailing address:
  • Phone: 813-451-5766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberAPRN11018284
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11018284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: