Healthcare Provider Details

I. General information

NPI: 1770430209
Provider Name (Legal Business Name): KELSEY ANSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 NEIL AVE
COLUMBUS OH
43210-1216
US

IV. Provider business mailing address

209 FAIRVIEW AVE
MARYSVILLE OH
43040-9705
US

V. Phone/Fax

Practice location:
  • Phone: 614-738-3129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042554
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.518440
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: