Healthcare Provider Details

I. General information

NPI: 1760168959
Provider Name (Legal Business Name): KELSEY ANNE BENTZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 GOOD DRIVE SUITE 11
LANCASTER PA
17601-2433
US

IV. Provider business mailing address

694 GOOD DRIVE SUITE 11
LANCASTER PA
17601-2433
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3737
  • Fax: 717-544-3739
Mailing address:
  • Phone: 717-544-3737
  • Fax: 717-544-3739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS025933
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: