Healthcare Provider Details

I. General information

NPI: 1881257244
Provider Name (Legal Business Name): KELSEY MARIE HAYDEN-WHITEMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY MARIE HAYDEN DO

II. Dates (important events)

Enumeration Date: 04/20/2019
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 FORGE RD STE 300
CARLISLE PA
17013-3183
US

IV. Provider business mailing address

138 COPPERLEAF DR
MECHANICSBURG PA
17050-9206
US

V. Phone/Fax

Practice location:
  • Phone: 717-218-3920
  • Fax:
Mailing address:
  • Phone: 717-314-9799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS022052
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: