Healthcare Provider Details

I. General information

NPI: 1407421803
Provider Name (Legal Business Name): KELSIE MARIE KUHNS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSIE MARIE GOULD MD

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-8809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLP05554
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number289627
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: