Healthcare Provider Details

I. General information

NPI: 1558071449
Provider Name (Legal Business Name): KELSEY DAMM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY CHLUPSA RN

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 LONE OAK RD
PADUCAH KY
42003-7901
US

IV. Provider business mailing address

315 HOSPITAL DR
MADISON TN
37115-5030
US

V. Phone/Fax

Practice location:
  • Phone: 270-444-2444
  • Fax:
Mailing address:
  • Phone: 615-732-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4049486
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: