Healthcare Provider Details

I. General information

NPI: 1114587847
Provider Name (Legal Business Name): KELSEY STOKER DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY CARTER BSN, RN

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 10/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 ASTOR ST
WELLFORD SC
29385-9622
US

IV. Provider business mailing address

102 ASTOR ST
WELLFORD SC
29385-9622
US

V. Phone/Fax

Practice location:
  • Phone: 864-439-5338
  • Fax:
Mailing address:
  • Phone: 864-439-5338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22943
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: