Healthcare Provider Details

I. General information

NPI: 1639921349
Provider Name (Legal Business Name): KELSEY KEE MS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

468 HALLE PARK DR
COLLIERVILLE TN
38017-7089
US

IV. Provider business mailing address

468 HALLE PARK DR
COLLIERVILLE TN
38017-7089
US

V. Phone/Fax

Practice location:
  • Phone: 901-295-5330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6722
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: