Healthcare Provider Details

I. General information

NPI: 1821732496
Provider Name (Legal Business Name): KELSEY KOLBE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N WASHINGTON ST STE 490
ALEXANDRIA VA
22314-1940
US

IV. Provider business mailing address

802 SUMMIT AVE
ALEXANDRIA VA
22302-2836
US

V. Phone/Fax

Practice location:
  • Phone: 703-765-6093
  • Fax: 615-936-3601
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101284670
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: