Healthcare Provider Details

I. General information

NPI: 1619208881
Provider Name (Legal Business Name): KELSEY B YEOMANS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY B GRABOW CRNA

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W WESTERN AVE STE B
MUSKEGON MI
49440-1045
US

IV. Provider business mailing address

1316 MERCY DR
MUSKEGON MI
49444-1835
US

V. Phone/Fax

Practice location:
  • Phone: 231-726-4498
  • Fax: 231-726-4468
Mailing address:
  • Phone: 231-739-9461
  • Fax: 231-739-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704235759
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: