Healthcare Provider Details

I. General information

NPI: 1568407385
Provider Name (Legal Business Name): KELSEY M. PARENTE PA-C, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 RAY C. HUNT DRIVE 310
CHARLOTTESVILLE VA
22906-0001
US

IV. Provider business mailing address

PO BOX 9007
CHARLOTTESVILLE VA
22906-9007
US

V. Phone/Fax

Practice location:
  • Phone: 434-243-5432
  • Fax: 434-243-0290
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110003789
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: